Neutrophil-to-lymphocyte ratio as a prognostic factor for survival in patients with colorectal liver metastases: A systematic review

Table 3 Univariate and multivariate analysis results after hepatectomy

Ref.	Univariate analysis	Multivariate analysis
Erstad et al[13]	NLR > 5 was significantly associated with reduced OS (P = 0.001)	NLR > 5 associated with reduced OS (P = 0.032)
Halazun et al[14]	NLR > 5 was associated with reduced OS (P < 0.0001); NLR > 5 was the sole positive predictor of recurrence (P < 0.0001)	NLR > 5 was associated with reduced OS (P < 0.0001)
Kishi et al[15]	NLR > 5 predicted worse survival (P = 0.011)	NLR > 5 predicted worse survival using variables available before surgery (P = 0.016) and after surgery (P = 0.048)
Neal et al[16]	NLR > 5 was significantly associated with worse OS (P = 0.001) and CSS (P < 0.001) following metastasectomy	NLR > 3 was associated with shorter survival (P < 0.001); NLR > 3 was associated with adverse outcomes regarding CSS (P < 0.001)
Hand et al[17]	Following index hepatectomy, patients with NLR > 5 had a median survival of 55 mo vs 70 mo when NLR < 5 (P = 0.027); Following neoadjuvant chemotherapy, no association between NLR and survival was demonstrated (P = 0.93); NLR > 5 had no impact on prognosis following repeat hepatectomy	There is an independent association between elevated preoperative neutrophil count and shortened overall survival (P = 0.001); no such association was found for NLR
Peng et al[18]	Patients with NLR > 4.63 were more likely to present multiple hepatic metastases than those with low NLR (68.8% vs 40.3%, P = 0.030); 5-year RFS and OS for high NLR were significantly inferior to those for low NLR (RFS: 12.5% vs 38.5%, P = 0.015; OS: 18.8% vs 46.7%, P = 0.004)	NLR was not identified as an independent inflammatory factor for better RFS
Kim et al[19]	NLR > 1.94 was a prognostic factor for poor OS (P = 0.035) and DFS; High NLR was associated with recurrence (P = 0.031)	NLR > 1.94 was an independent prognostic factor for OS (P = 0.01) and prognostic factor for poor DFS; High NLR was associated with recurrence (P = 0.006)
Mao et al[20]	Pre- and post-chemotherapy NLR > 2.3 was associated with decreased OS (P = 0.012)	NLR > 2.3 was a significant predictor both for worse OS (P < 0.001) and for RFS (P = 0.017)
Neofytou et al[21]	NLR > 2.4 was associated with decreased DFS (P = 0.033) and OS (P = 0.007)	No significant correlation was found between NLR and OS/DFS
Giakoustidis et al[22]	NLR > 2.5 was associated with decreased OS (P = 0.009) and decreased DFS (P = 0.09)	High NLR remained a significant prognostic factor for poor OS (P = 0.012)
Dupré et al[23]	NLR of 2.5 was an independent prognostic factor for OS and PFS	High NLR was significantly associated with decreased OS (P < 0.002)
Hamada et al[24]	NLR > 4.1 was significantly correlated with better CSS (P = 0.026)	Only univariate analysis was performed
Zeman et al[25]	NLR > 5 was significantly associated with DFS (P = 0.044); OS was significantly affected by the preoperative number of leukocytes (P = 0.0014) and neutrophils (P = 0.0036) but not by the NLR.	NLR > 5 was significantly associated with DFS (P = 0.03); Leukocyte number was significantly associated with OS (P = 0.0014); no effect of NLR was demonstrated on OS

NLR: Neutrophil to lymphocyte ratio; OS: Overall survival; CSS: Cancer-specific survival; RFS: Recurrence-free survival; DFS: Disease-free survival.