Prognostic Value of Pretreated Blood Inflammatory Markers in Patients with Bone Sarcoma: A Meta-Analysis

Abstract

Backgroud. Multiple studies have reported blood inflammatory markers as reliable prognostic factors in various malignant tumors. However, their prognostic effect in patients with bone sarcomas has not been determined. We performed this meta-analysis to evaluate the prognostic value of pretreated blood inflammatory markers in patients with bone sarcoma. Method. We conducted a detailed literature search in Medline and Embase databases and collected relevant publications written in English before April 2020. Overall survival (OS) and disease-free survival (DFS) were the primary and secondary outcomes, respectively. Basic features of patients, hazard ratios (HRs), and 95% confidence intervals (CI) were retrieved to assess the correlation between pretreated blood inflammatory markers and patients with bone sarcoma. This meta-analysis used Stata 12.0. Results. A total of 10 studies containing 1845 cases were included for analysis. Nine of them evaluated the neutrophil lymphocyte ratio (NLR), 7 the platelet lymphocyte ratio (PLR), and 4 the lymphocyte monocyte ratio (LMR). Pooled results revealed that higher pretreatment NLR was associated with poorer OS (HR=1.76, 95% CI: 1.29-2.41, and P<0.001) and DFS (HR=1.77, 95% CI: 1.09-2.88, and P=0.021). In contrast, a lower LMR was related to worse OS (HR=0.73, 95% CI: 0.57-0.92, and P=0.009), but not DFS (HR=0.68, 95% CI: 0.41-1.11, and P>0.05). Combined results did not show a significant predictive effect of PLR on the clinical outcomes of patients with bone sarcoma (OS:HR=1.32, 95% CI: 0.99-1.75, and P>0.05; DFS: HR=1.12, 95% CI: 0.87-1.44, P>0.05). Conclusion. NLR and LMR might be promising predictive biomarkers for patients with bone sarcoma and could be used to stratify patients and provide personalized therapeutic strategies.