# A Review of the Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Nonhematologic Malignancies

## TL;DR

This review summarizes how the neutrophil-to-lymphocyte ratio (NLR) can predict outcomes in non-blood cancers, based on recent studies from 2018 to 2024.

## Contribution

The paper provides an updated synthesis of NLR's role in nonhematologic cancers, including a Q&A section for practical insights.

## Key findings

- NLR is a reliable prognostic indicator across multiple nonhematologic cancer types.
- The review includes 88 studies with 28,050 subjects, grouped into gastrointestinal, urinary/reproductive, lung, and breast cancers.
- The paper highlights NLR's limitations and exceptions in clinical use.

## Abstract

Biomarkers are crucial in cancer diagnostics, prognosis, and surveillance. Extensive research has been dedicated to identifying biomarkers that are broadly applicable across multiple cancer types and can be easily obtained from routine investigations such as blood cell counts. One such biomarker, the neutrophil-to-lymphocyte ratio (NLR), has been established as a prognostic marker in cancer. However, due to the dynamic nature of cancer diagnosis and treatment, periodic updates are necessary to keep abreast of the vast amount of published data. In this review, we searched the PubMed database and analyzed and synthesized recent literature (2018–February 2024) on the role of NLR in predicting clinical outcomes in nonhematologic malignancies. The search was conducted using the PubMed database. We included a total of 88 studies, encompassing 28,050 human subjects, and categorized the findings into four major groups: gastrointestinal cancer, cancers of the urinary tract and reproductive system, lung cancer, and breast cancer. Our analysis confirms that NLR is a reliable prognostic indicator in cancer, and we discuss the specific characteristics, limitations, and exceptions associated with its use. The review concludes with a concise Q&A section, presenting the most relevant take-home messages in response to five key practical questions on this topic.