Prognostic value of pretreatment lymphocyte-to-monocyte ratio in patients with urologic tumors: A PRISMA-compliant meta-analysis

Jialin Li, Yusheng Cheng, Zhigang Ji, Jialin Li, Yusheng Cheng, Zhigang Ji

Abstract

Background: The prognostic value of pretreatment lymphocyte to monocyte ratio (LMR) in patients with urologic tumors remains controversial. Therefore, we herein conducted a meta-analysis to systematically assess the prognostic value of LMR in patients with urologic tumors.

Methods: We comprehensively searched PubMed, EMBASE and Web of Science to identify eligible studies. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were used to assess the prognostic value of LMR in patients with urologic tumors. This meta-analysis was registered in PROSPERO (CRD42018108959).

Results: A total of 20 studies were included in this meta-analysis. Our synthesized analysis showed that low LMR was significantly correlated with poor overall survival (OS) and progression-free survival (PFS) in patients with upper tract urothelial cancer (UTUC). We also found that renal cell cancer (RCC) patients with low LMR had poor OS, PFS and cancer-specific survival (CSS). Besides, it was observed that low LMR predicted poor OS, RFS and CSS in patients with bladder cancer (BC).

Conclusion: This meta-analysis demonstrated that pretreatment LMR is associated with survival, and may be a useful prognostic parameter in urologic tumors. Nevertheless, more prospective and heterogeneous studies with large samples are required to further confirm our findings before it is applied for daily clinical decision making.

Conflict of interest statement

All the authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of identifying eligible studies.
Figure 2
Figure 2
The synthesized HR assessing the prognostic value of pretreatment LMR for OS (A), PFS (B) and DFS (C) in upper tract urothelial cancer. DFS = disease-free survival, HR = hazard ratio, LMR = lymphocyte-to-monocyte ratio, OS = overall survival, PFS = progression-free survival.
Figure 3
Figure 3
The synthesized HR assessing the prognostic value of pretreatment LMR for OS (A), CSS (B) and PFS (C) and in renal cell cancer. CSS = cancer-specific survival, HR = hazard ratio, LMR = lymphocyte-to-monocyte ratio, OS = overall survival, PFS = progression-free survival.
Figure 4
Figure 4
The sensitivity analysis of the synthesized HR assessing the prognostic value of pretreatment LMR for OS in renal cell cancer (A). The funnel plot of Begg test for the publication bias assessment of the synthesized HR assessing the prognostic value of pretreatment LMR for OS in renal cell cancer (B). HR = hazard ratio, LMR = lymphocyte-to-monocyte ratio, OS = overall survival.
Figure 5
Figure 5
The synthesized HR assessing the prognostic value of pretreatment LMR for OS in bladder cancer. LMR = lymphocyte-to-monocyte ratio, OS = overall survival.
Figure 6
Figure 6
The synthesized HR assessing the prognostic value of pretreatment LMR for RFS (A), CSS (B) and PFS (C) in bladder cancer. CSS = cancer-specific survival, HR = hazard ratio, LMR = lymphocyte-to-monocyte ratio, OS = overall survival, PFS = progression-free survival, RFS = recurrence-free survival.
Figure 7
Figure 7
The sensitivity analysis of the synthesized HR assessing the prognostic value of pretreatment LMR for OS in bladder cancer. HR = hazard ratio, LMR = lymphocyte-to-monocyte ratio, OS = overall survival.
Figure 8
Figure 8
The funnel plot of Begg test for the publication bias assessment of the synthesized HR assessing the prognostic value of pretreatment LMR for OS in bladder cancer (A). The adjusted funnel plot of Begg test for the publication bias assessment of the synthesized HR assessing the prognostic value of pretreatment LMR for OS in bladder cancer (B). HR = hazard ratio, LMR = lymphocyte-to-monocyte ratio, OS = overall survival.

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