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Prognostic value of pre-treatment advanced lung cancer inflammation index in non-small cell lung cancer: a meta-analysis

Abstract Purpose To identify the prognostic value of pre-treatment advanced lung cancer inflammation index (ALI) in non-small cell lung cancer (NSCLC) including surgical patients who were diagnosed with early stage. Methods The PubMed, EMBASE and Web of Science electronic databases were searched up to January 12, 2022 for relevant studies. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to assess the association between pre-treatment ALI and overall survival (OS) or progression-free survival (PFS) of NSCLC patients. All statistical analyses were conducted by STATA 12.0 software. Results A total of 14 studies involving 3607 participants were included. The pooled results indicated that lower pre-treatment ALI was significantly related to poorer OS (HR = 2.20, 95% CI: 1.46–3.33, P < 0.001) and PFS (HR = 1.78, 95% CI: 1.49–2.13, P < 0.001). Besides, subgroup analysis also demonstrated that lower pre-treatment ALI was associated with worse OS in surgical (P < 0.001) and non-metastatic (P < 0.001) patients and worse PFS of surgical (P < 0.001) NSCLC patients. Conclusion Pre-treatment ALI was a novel and reliable prognostic indicator in NSCLC and lower pre-treatment ALI predicted worse survival including patients diagnosed with early stage. However, more prospective high-quality studies are still needed to verify the above findings.