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Table 1 Main characteristics of all the studies included in the meta-analysis

From: Prognostic value of systemic inflammatory markers in ovarian Cancer: a PRISMA-compliant meta-analysis and systematic review

Study, (Author/year/Country)

Cancer traits

Treatment

Patients

Age,

Follow-up, months (Range)

Therapy Response/Survival Data

NOS Score

Miao/2016/China [10]

EOC; Serous papillary histology (n = 216, 62.8%); FIGO stage III (n = 168, 48.8%); platinum-resistant group (n = 96, 27.9%);

Comprehensive surgical staging or tumor debulking followed by 6 cycles of adjuvant chemotherapy.

344

55 (45–84)

72 (61-97)

PFS (HR)

PLR (cut-off value: 207)

Ua: 3.851 (2.958 to 5.014)

Ma: 1.952 (1.430 to 2.662)

NLR (cut-off value: 3.02)

Ua: 5.093 (3.886 to 6.676)

Ma: 1.733 (1.225 to 2.453)

OS (HR)

PLR (cut-off value: 207)

Ua: 3.863 (2.960 to 5.043)

Ma: 2.167 (1.565 to 3.000)

NLR (cut-off value: 3.02)

Ua: 4.970 (3.794 to 6.511)

Ma: 1.616 (1.138 to 2.297)

9

Wang/2015/China [12]

SOC; FIGO stage III-IV (n = 93, 73.8%)

Cytoreductive surgery including para-aortic and pelvic lymph node dissection followed by platinum-based chemotherapy.

126

NA

41.3 (3.3–70.4)

PFS (HR)

PLR (cut-off value: 187.6)

Ua: 1.306 (0.684–2.495)

Ma: 1.127 (0.433–2.932)

NLR (cut-off value: 2.65)

Ua: 3.191 (1.514–6.728)

Ma: 3.554 (1.389–9.096)

OS (HR)

PLR (cut-off value: 187.6)

Ua: 1.090 (0.510–2.329)

Ma: 1.689 (0.590–4.835)

NLR (cut-off value: 2.65)

Ua: 3.775 (1.497–9.519)

Ma: 5.302 (1.817–15.471

8

Cho/2009/Korea [13]

EOC; Serous papillary histology (n = 131, 68.2%); FIGO stage III-IV (n = 125, 65.1%)

Treatment according to NCCN guidelines.

192

51.8 ± 12.9

20.9

DFS

P = 0.014

OS (HR)

NLR (cut-off value: 2.6)

Ua: 6.05 (1.77–20.71)

Ma: 8.42 (1.09–64.84)

8

Wang/2016/China [14]

OC; EOC (N = 122 85.3%); FIGO stage III-IV (n = 89, 62.2%)

NA

143

52.3 ± 14.1

 

PFS (HR)

PLR (cut-off value: 201)

Ua: 1.43 (0.87–2.35)

Ma: 1.71 (0.80—3.66)

NLR (cut-off value: 3.43)

Ua: 2.11 (1.29–3.46)

Ma: 2.20 (1.03–4.70)

OS (HR)

PLR (cut-off value: 201)

Ua: 1.76 (1.02–3.06)

Ma: 2.05 (0.85–4.95)

NLR (cut-off value: 3.43)

Ua: 2.90 (1.66–5.05)

Ma: 3.37 (1.39–8.15)

8

Asher/2011/UK [15]

OC; Serous papillary histology (n = 117, 49.6%); FIGO stage III-IV (n = 141, 60%)

Surgery followed by chemotherapy

235

62 (24–90)

24.5 (0.3–191.1)

NA

OS (HR)

PLR (cut-off value: 300)

Ua: 1.863 (1.37–2.534)

Ma: 1.698 (1.031–2.797)

NLR (cut-off value: 4)

Ua: 1.686 (1.231–2.310)

Ma: 0.865 (0.521–1.437)

7

Williams/2014/USA [16]

OC; Serous papillary histology (n = 300, 58%); FIGO stage III-IV (n = 308, 61%)

NA

519

≥55 ys: 56%

68.4 (1-252)

NA

OS (HR)

NLR (cut-off value: 3.6)

Ua: 1.43 (1.13,1.81)

Ma: 1.37 (1.06, 1.76)

7

Thavaramara/2011/Thailand [17]

EOC; FIGO stage III-IV (n = 61, 47.6%)

Gynecologic surgery followed by chemotherapy

129

49.6 ± 12.5

NA

PFS (HR)

NLR (cut-off value: 2.8)

Ua: NA

Ma: 0.7 (0.3-1.4)

OS (HR)

NLR (cut-off value: 2.8)

Ua: NA

Ma: 0.7 (0.3-1.6)

8

Raungkaewmanee/2014/ Thailand [11]

EOC; Serous papillary histology (n = 136, 81.9%); FIGO stage III-IV (n = 78, 47%)

Surgery followed by chemotherapy

166

53 (23-85)

28.3 (6.1-94.4)

PFS (HR)

PLR (cut-off value: 200)

Ua: 1.89 (1.24–2.88)

Ma: 1.51 (0.88-2.61)

PFS (HR)

NLR (cut-off value: 2.6)

Ua: 1.16 (0.91-1.49)

Ma: NA

OS (HR)

PLR (cut-off value: 200)

Ua: 2.67 (1.43–4.98)

Ma: 1.41 (0.77-2.56)

OS (HR)

NLR (cut-off value: 2.6)

Ua: 1.19 (0.72-1.98)

Ma: NA

9

Feng/2016/ China [18]

HGSC; FIGO stage III-IV (n = 800, 91.4%)

Primary staging or debulking surgery, and 66.9% patients followed by chemotherapy

875

56 (30–90)

29 (1–115)

PFS (HR)

NLR (cut-off value: 3.24)

Ua: NA

Ma: 1.250 (1.052–1.484)

OS (HR)

NLR (cut-off value: 3.24)

Ua: NA

Ma: 1.189 (0.940–1.504)

8

Zhang/2015/ China [19]

OC; FIGO stage III-IV (n = 137, 72.1%)

cytoreductive surgery followed by platinum-based chemotherapy

190

51 (24–76)

43 (2–164)

PFS (HR)

PLR (cut-off value: 203)

Ua: 2.224 (1.626–3.042)

Ma: 1.852 (1.271–2.697)

NLR (cut-off value: 3.4)

Ua: 2.012 1.476–2.741

Ma: NA

OS (HR)

PLR (cut-off value: 203)

Ua: 2.490 (1.758–3.527)

Ma: 2.158 (1.468–3.171)

NLR (cut-off value: 3.4)

Ua: 2.172 (1.545–3.054)

Ma: NA

9

  1. PFS progression-free survival, OS overall survival, CI confidence interval, OC ovarian cancer, EOC epithelial ovarian cancer, HGSC high-grade serous ovarian cancer, HR hazard ratio, NLR neutrophil to lymphocyte ratio, PLR platelet to lymphocyte ratio, ROC receiver operating characteristic, AUC area under curve, SOC serous ovarian cancer, NCCN National Comprehensive Cancer Network, NA none acquired