The lymphocyte-to-monocyte ratio as a prognostic indicator in head and neck cancer: a systematic review and meta-analysis
- 197 Downloads
The aim of this systematic review and meta-analysis was to investigate the relationship between the pre-treatment lymphocyte-to-monocyte ratio (LMR) and prognosis in HNC.
PubMed (via the Web), Embase, Scopus, and the Cochrane Library were searched. A systematic review and meta-analysis was done to generate the pooled hazard ratios (HR) for overall survival (OS) and disease-free survival (DFS).
Our analysis included the results of 4260 patients in seven cohorts. The pooled data demonstrated that an elevated LMR was associated with significantly improved OS (HR 0.5; 95% CI 0.44–0.57), and DFS (HR 0.70; 95% CI 0.62–0.80). Of note, there was no detectable heterogeneity in either OS (I2 = 0%) or DFS (I2 = 0%).
An elevated LMR may be an indicator of favorable prognosis in HNC. However, our results should be interpreted with some degree of caution due to the retrospective nature of cohort studies. Further research with high-quality prospective studies is needed to confirm the effect of LMR in HNC prognosis.
KeywordsLymphocyte–monocyte ratio LMR Inflammatory markers Prognosis Head and neck cancer Meta-analysis Systematic review
No funding was received for this study.
Compliance with ethical standards
Conflict of interest
The authors have no financial or personal disclosures, or conflicts of interest.
- 7.Macaskill P, Gatsonis C, Deeks J, Harbord R, Takwoingi Y. Cochrane handbook for systematic reviews of diagnostic test accuracy. Version 09 0 London: The Cochrane Collaboration. 2010Google Scholar
- 10.PROSPERO ID:80658 [Internet]. 2017. Available from: https://www.crd.york.ac.uk/prospero/ [Pending Approval]
- 20.Ong HS, Gokavarapu S, Wang LZ, Tian Z, Zhang CP (2016) Low pretreatment lymphocyte–monocyte ratio and high platelet–lymphocyte ratio indicate poor cancer outcome in early tongue cancer. J Oral Maxillofac Surg 75(8):1762–1774Google Scholar
- 22.Li XH, Chang H, Xu BQ et al (2016) An inflammatory biomarker-based nomogram to predict prognosis of patients with nasopharyngeal carcinoma: an analysis of a prospective study. Cancer Med 6(1):310–319Google Scholar
- 23.Ryan R; Cochrane Consumers and Communication Review Group (2016) Heterogeneity and subgroup analyses in cochrane consumers and communication group reviews: planning the analysis at protocol stage. http://cccrg.cochrane.org