The elevated pretreatment platelet-to-lymphocyte ratio predicts poor outcome in nasopharyngeal carcinoma patients

The aim of this study was to evaluate whether the platelet-to-lymphocyte ratio (PLR) could be used to predict the prognosis of patients with nasopharyngeal carcinoma (NPC). Patients (n = 1261) who were diagnosed with nonmetastatic NPC between January 2008 and December 2010 were recruited. The peripheral platelet and lymphocyte counts were retrieved, and the PLR was calculated. Univariate and multivariate Cox proportional hazards analyses were used to assess their association with PLR: overall survival (OS), cancer-specific survival (CSS), and distant metastasis-free survival (DMFS). The elevated PLR, using the third quartile values (153.64) as the optimal cutoff values, was found to be associated with the significant decline in CSS (hazard ratio [HR] 1.83, 95 % confidence interval [CI] 1.27–2.63, P < 0.001), OS (HR 1.81, 95 % CI 1.28–2.56, P < 0.001), and DMFS (HR 1.60, 95 % CI 1.15–2.23, P = 0.005) that remained significant during the multivariable analyses (CCS HR 1.84, 95 % CI 1.26–2.67, P < 0.001; OS HR 1.83, 95 % CI 1.28–2.61, P < 0.001; DMFS HR 1.56, 95 % CI 1.11–2.19, P = 0.011). Subgroup analyses indicated that the PLR could be used to stratify prognosis effectively for patients with early- or advanced-stage NPC, and Epstein–Barr virus DNA levels of ≥1500 copies/mL. In conclusions, elevated PLR values were associated with poor CSS, OS, and DMFS for patients with NPC; this easily accessed variable based on a large amount of cases multivariate analysis is valuable for predicting prognosis in patients with NPC.