Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Oncol. Nov 15, 2026; 18(11): 124040
Published online Nov 15, 2026. doi: 10.4251/wjgo.124040
Published online Nov 15, 2026. doi: 10.4251/wjgo.124040
Elevated pretreatment neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio predict poor survival in cholangiocarcinoma: A large-scale meta-analysis of 48 cohorts
Wen-Miao Cai, Wei Jiang, Bao-Feng He, Jun-Jie Yu, Xian-Hua Zeng, Sun Liu, Department of Surgery, First People’s Hospital of Changde City, Changde 410000, Hunan Province, China
Lei Peng, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510000, Guangdong Province, China
Co-first authors: Wen-Miao Cai and Wei Jiang.
Co-corresponding authors: Lei Peng and Sun Liu.
Author contributions: Cai WM, He BF, Yu JJ, Zeng XH, Peng L, and Liu S contributed to manuscript review and editing; Cai WM, Jiang W, Yu JJ, and Zeng XH contributed to supervision; Cai WM, Jiang W, Yu JJ, Zeng XH, and Peng L contributed to methodology; Cai WM contributed to resources, project administration, and conceptualization; Cai WM and Jiang W contributed equally to this manuscript as co-first authors; Cai WM, Jiang W, He BF, and Zeng XH contributed to investigation; Jiang W and Yu JJ contributed to formal analysis; Jiang W contributed to writing of the original draft; Jiang W and Liu S contributed to data curation; Peng L and Liu S contributed equally to this manuscript as co-corresponding authors. All authors have read and approved the final manuscript.
AI contribution statement: The authors used Grammarly solely for English language editing and proofreading of the manuscript. The authors reviewed and edited the AI-generated text and take full responsibility for the content and accuracy of the final publication.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Lei Peng, PhD, Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Zhongshan Avenue, Guangzhou 510000, Guangdong Province, China. 1015425249@qq.com
Received: June 4, 2026
Revised: July 16, 2026
Accepted: July 30, 2026
Published online: November 15, 2026
Processing time: 144 Days and 19.5 Hours
Revised: July 16, 2026
Accepted: July 30, 2026
Published online: November 15, 2026
Processing time: 144 Days and 19.5 Hours
Core Tip
Core Tip: Pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio serve as significant prognostic biomarkers for cholangiocarcinoma. This meta-analysis of 48 cohorts confirms that elevated NLR and platelet-to-lymphocyte ratio correlate with poorer overall and disease-free survival. Notably, NLR demonstrates superior predictive value in patients receiving palliative therapy compared to those undergoing curative surgery. These findings suggest that NLR is a valuable tool for risk stratification in unresectable cases. However, the lack of standardized cut-off values necessi