Non-Cochrane · prognostic · PM41402518
Hematological parameters as predictors of oral cancer prognosis: a systematic review and meta-analysis.
Alshahrani Abdullah M, Kaur Kanwalpreet, Saini Ravinder S, et al. · Journal of cancer research and clinical oncology · 2025 · PubMed · doi:10.1007/s00432-025-06394-5
Findings
24 findings
| Population | ||||
|---|---|---|---|---|
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Overall survival Multivariate-adjusted studies only | HR 1.45 [1.20, 1.75] GRADE not reported 10 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Disease-free survival | HR 1.66 [1.31, 2.10] 65% vs 50% GRADE not reported 12 studies · 3100 participants |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Overall survival Leave-one-out (lowest HR study excluded) | HR 1.60 [1.35, 1.95] GRADE not reported 14 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Overall survival | HR 1.59 [1.32, 1.92] 70% vs 55% Moderate Downgraded: inconsistency 15 studies · 4180 participants |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Overall survival NLR cut-off > 3.0 | HR 1.45 [1.20, 1.70] GRADE not reported 7 studies |
| Patients with pathologically confirmed oral squamous cell carcinoma | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Overall survival Figure 2 panel a forest plot pooled diamond Unresolved: the two extractors disagree on this row. | HR 1.90 [1.65, 2.18] GRADE not reported 15 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Disease-specific survival | HR 1.50 [1.10, 2.05] GRADE not reported 5 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Overall survival Excluding low-quality studies (NOS <= 5) | HR 1.55 [1.25, 1.90] GRADE not reported 8 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Overall survival NLR cut-off <= 3.0 | HR 1.70 [1.35, 2.05] GRADE not reported 8 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Overall survival Leave-one-out (highest HR study excluded) | HR 1.57 [1.30, 1.85] GRADE not reported 14 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment neutrophil-to-lymphocyte ratio (NLR) | Low pre-treatment NLR | Nodal metastasis at diagnosis Unresolved: the two extractors disagree on this row. | OR 1.61 [1.30, 1.98] 42% vs 55% Low Downgraded: imprecision 7 studies · 1200 participants |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment platelet-to-lymphocyte ratio (PLR) | Low pre-treatment PLR | Overall survival PLR cut-off <= 150 | HR 1.70 [1.35, 2.05] GRADE not reported 9 studies |
| Patients with pathologically confirmed oral squamous cell carcinoma | High pre-treatment platelet-to-lymphocyte ratio (PLR) | Low pre-treatment PLR | Overall survival Figure 2 panel b forest plot pooled diamond Unresolved: the two extractors disagree on this row. | HR 1.68 [1.42, 2.00] GRADE not reported 15 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment platelet-to-lymphocyte ratio (PLR) | Low pre-treatment PLR | Overall survival PLR cut-off > 150 | HR 1.40 [1.15, 1.65] GRADE not reported 10 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment platelet-to-lymphocyte ratio (PLR) | Low pre-treatment PLR | Overall survival Excluding low-quality studies (NOS <= 5) | HR 1.52 GRADE not reported Studies not reported |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment platelet-to-lymphocyte ratio (PLR) | Low pre-treatment PLR | Disease-free survival Unresolved: the two extractors disagree on this row. | HR 1.50 [1.18, 1.90] 60% vs 48% Low Downgraded: risk of bias, inconsistency 9 studies · 2300 participants |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment platelet-to-lymphocyte ratio (PLR) | Low pre-treatment PLR | Overall survival Unresolved: the two extractors disagree on this row. | HR 1.58 [1.29, 1.94] 65% vs 50% Low Downgraded: risk of bias, inconsistency 19 studies · 5714 participants |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment platelet-to-lymphocyte ratio (PLR) | Low pre-treatment PLR | Overall survival Trim-and-fill adjusted (2 studies imputed) | HR 1.45 [1.18, 1.78] GRADE not reported Studies not reported |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment NLR or PLR (marker not specified) | Low pre-treatment NLR or PLR | Survival (outcome not specified) Surgery only | HR 1.55 [1.20, 1.90] GRADE not reported 8 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment NLR or PLR (marker not specified) | Low pre-treatment NLR or PLR | Survival (outcome not specified) Asian studies | HR 1.65 [1.30, 2.00] GRADE not reported 10 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment NLR or PLR (marker not specified) | Low pre-treatment NLR or PLR | Survival (outcome not specified) Sample size > 200 patients | HR 1.45 [1.15, 1.75] GRADE not reported 7 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment NLR or PLR (marker not specified) | Low pre-treatment NLR or PLR | Survival (outcome not specified) Mixed or CRT treatment | HR 1.65 [1.30, 2.00] GRADE not reported 7 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment NLR or PLR (marker not specified) | Low pre-treatment NLR or PLR | Survival (outcome not specified) Sample size <= 200 patients | HR 1.70 [1.40, 2.00] GRADE not reported 8 studies |
| Patients with oral squamous cell carcinoma (OSCC) | High pre-treatment NLR or PLR (marker not specified) | Low pre-treatment NLR or PLR | Survival (outcome not specified) Non-Asian studies | HR 1.50 [1.20, 1.80] GRADE not reported 5 studies |
Included primary studies 27
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Nakashima 2016 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Perisanidis 2013 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Ruiz-Ranz 2022 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Sano 2018 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Tazeen 2020 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Trevisani 2023 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Tsai 2022 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Watabe 2021 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Zakaria 2022 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Chen 2017 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Demir and Abuzaid 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Diana 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Huang CH 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Kao (Chang) 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Khazravi 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Mishra 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Ning 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Ozturk 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Park 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Park 2017 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Takahashi 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Valero 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Wongrakpanich 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Yang 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Zhilin 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Zhuang 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Zubair 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Preoperative Inflammatory Blood Indices as Prognostic Markers in Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis. (2026) | 9 | 0.18 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with pathologically confirmed oral squamous cell carcinoma (oral cavity and tongue), any stage and treatment | OSCC patients, about 7940 across 35 studies (n=35) |
| Intervention | High pre-treatment NLR, PLR or MPV (cut-offs as defined by each study) | High NLR (n=15 for OS); high PLR (n=19 for OS); high MPV (n=3, not pooled) |
| Comparison | Low pre-treatment NLR, PLR or MPV | Low NLR, PLR or MPV |
| Outcomes | Overall survival, disease-free survival; disease-specific survival, recurrence, nodal metastasis and other clinicopathological factors | OS (NLR n=15, PLR n=19); DFS (NLR n=12, PLR n=9); DSS (NLR n=5); nodal metastasis (NLR n=7) |
| Study designs | Observational studies (retrospective or prospective cohorts, case-control); English language | 35 observational studies, 33 retrospective cohorts and 2 earlier meta-analyses (n=35); 30 in meta-analysis |
| Timing | Published 2000 to April 2025 | Not specified |