SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1642181
This article is part of the Research TopicThe Ecosystem of Inflammation and Cancer in Ulcerative Colitis and Colorectal CancerView all articles
Prognostic value of platelet to lymphocyte ratio in patients with colorectal cancer undergoing chemotherapy: a systematic review and meta-analysis
Provisionally accepted
- 1Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- 2Department of Cardiovascular Medicine, The First Affiliated Hospital of Yangtze University, Hubei, China
- 3Department of Gastroenterology,Xijing Hospital ,The Fourth Military Medical University, Xi'an, China
- 4Department of Gastroenterology,Xijing Hospital ,The Fourth Military Medical University, Xi'an, China
- 5Department of Psychiatry ,Xijing Hospital ,The Fourth Military Medical University, Xi'an, China
- 6Department of Culture and Art Studies，Basic Medical Science Academy,The Fourth Military Medical University, Xi'an, China
- 7Department of nursing，Xijing Hospital ,The Fourth Military Medical University, Xi'an, China
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Background: Emerging evidence suggests a correlation between the platelet-to-lymphocyte ratio (PLR) and the prognosis in patients with colorectal cancer (CRC) undergoing chemotherapy. Nevertheless, the existing findings remain contentious. Methods: An extensive literature review was carried out using PubMed, Embase, Web of Science, and the Cochrane Library up to February 20, 2025, to identify relevant studies on the prognostic role of PLR in clinical outcomes. We applied a set of predefined criteria to determine which studies qualified for inclusion. We assessed overall survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS) using hazard ratios (HR) and corresponding 95% confidence intervals (CI). Results: Our analysis included nineteen studies (26 comparative groups), involving 4,422 individuals. Aggregate data revealed a significant correlation between PLR values and both OS and PFS in CRC patients receiving chemotherapy (OS: HR = 1.18, 95% CI: 1.03–1.35; p = 0.02; PFS: HR = 1.28, 95% CI: 1.03–1.60; p = 0.03). Specifically, higher PLR values were associated with shorter OS and PFS. This association was observed across varying sample sizes, population characteristics, cut-off values, regions, treatments, and patient ages. However, no significant correlation was found between PLR values and CSS in CRC patients receiving chemotherapy (CSS: HR = 1.27, 95% CI: 0.76–2.10; p = 0.36). Conclusion: Higher PLR values are significantly associated with shorter OS and PFS in CRC patients undergoing chemotherapy. However, the analysis did not demonstrate a statistically significant relationship between PLR and CSS in this patient population. In patients with CRC, PLR may serve as a useful marker for predicting outcomes and shaping individualized therapeutic approaches, especially in the context of immunotherapy.
Keywords: Platelet to lymphocyte ratio1, colorectal cancer2, chemotherapy3, Prognostic valueof surviva4, Meta-analysis5
Received: 06 Jun 2025; Accepted: 22 Oct 2025.
Copyright: © 2025 Li, Juan, Zhou, Li, Shi, Chen and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xuehui Hu, 466980356@qq.com
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