**3.4. Meta-analyses of PLR in gastric cancer**

Several meta-analyses of PLR have been devoted to PLR in gastric cancer, yielding partially conflicting results. In a meta-analysis of 8 studies comprising 4513 cases of gastric carcinoma, elevated PLR correlated with lymph node metastasis, deeper invasion (T3–T4) and advanced cancer stage (III–IV) but it was not predictor of overall survival. The relevant odds ratios were 1.50 (95% CI = 1.24–1.82) for N+, 2.01 (95% CI = 1.49–2.73) for T3–T4 and 1.99 (95% CI = 1.60–2.46) for stage III–IV [85].

Fourteen cohorts and 6280 cases were re-evaluated within the frames of another meta-analysis. Authors found out that PLR was associated with poor overall survival but not with cancer-free survival. High PLR predicted poor survival in Caucasians, patients receiving chemotherapy and patients at advanced stage. Despite the controversies regarding survival, the association with lymph node metastases was reconfirmed [86].

Zhou et al. carried out a general meta-analysis devoted to the prognostic value of PLR in different cancers [89]. There was significant association between elevated PLR and worse overall survival (hazard ratio 1.60; 95% CI = 1.35–1.90). In the subgroup of gastric cancer, the HR was 1.35 (95% CI 0.80–2.25).
