Prognostic value of lymphocyte-to-monocyte ratio in ovarian cancer: a meta-analysis

Abstract

Introduction Prognostic biomarkers are highly needed to properly manage patients with cancer and improve their clinical courses. The relationship between lymphocyte-to-monocyte ratio (LMR) at diagnosis and ovarian cancer prognosis has been extensively studied, but little consensus has been reached regarding its utility as a biomarker of poor outcome. Thus, this study aimed to investigate the potential prognostic value of pretreatment LMR in such patients to shed light on this issue. Methods We searched the scientific databases of MEDLINE, Embase, Cochrane Library, and WangFang for relevant studies about the inflammatory prognostic factor LMR in ovarian cancer, based on specific inclusion and exclusion criteria. The following parameters were analyzed among others: LMR values and respective cut-offs, patient’s overall survival (OS) and progression-free survival (PFS), and clinicopathological features. Results Eight studies, including 2259 patients, were eligible for inclusion in this meta-analysis. We found that low LMR was associated with both poor OS [Hazard ratio (HR): 1.92; 95% confidence interval (CI): 1.58–2.34; p < 0.001] and PFS (HR: 1.70; 95% CI: 1.54–1.88; p < 0.001). Moreover, our findings revealed that low LMR was correlated with high G2/G3 histological grade (OR: 1.67; 95% CI: 1.26–2.20; p < 0.001) and late III-IV FIGO stage tumors (OR: 3.55; 95% CI: 2.68–4.70; p < 0.001), high serum CA-125 level (OR: 2.18; 95% CI: 1.71–2.77; p < 0.001), and presence of malignant ascites (OR: 1.87; 95% CI: 1.11–3.14; p = 0.02) and lymph node metastases (OR: 1.70; 95% CI: 1.13–2.54; p = 0.01). Conclusion Pretreatment LMR is a potential prognostic marker of poor outcome in ovarian cancer patients and may thus be important in clinical care and disease control.

Preoperative Lymphocyte-to-monocyte Ratio and CA125&nbsp;Level as Risk Factors for Advanced Ovarian Cancer

“…In this study, we attempted to determine preoperative indicators to stage OC to help attain ODS, reduce surgical complications and economic burden, and better evaluate the prognosis of OC patients. Multivariate logistic regression analysis showed that LMR was signi cantly associated with stage of OC (Table 3): the lower the LMR, the higher the stage, and the worse the prognosis, which was consistent with the conclusion of previous research [10]. Our study also showed that serum CA125 was associated with stage of OC (Table 3); however, the speci city was lower than LMR (Figs.…”

Preoperative LMR and Serum CA125 Level as Risk Factors for Advanced Stage of Ovarian Cancer

“…In this study, we attempted to explore preoperative indicators to stage OC to help predict optimal debulking surgery, reduce surgical complications and economic burden, and better evaluate the prognosis of OC patients. Multivariate logistic regression analysis showed that LMR was significantly associated with stage of OC (Table 3 ): the lower the LMR, the higher the stage, and the worse the prognosis, which was consistent with the conclusion of previous research 17 . Our study also showed that serum CA125 was associated with stage of OC (Table 3 ); however, the specificity was lower than LMR.…”

Decrease in Neutrophil-to-Lymphocyte Ratio during Neoadjuvant Chemotherapy as a Predictive and Prognostic Marker in Advanced Ovarian Cancer

“…Notably, in recent years, many researchers have investigated the value of blood constituents in the systemic inflammatory response and reported that single elements of a complete blood sample may have clinical utility in the prediction of cancer outcome. Many of these indexes, such as the platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and, in particular, the NLR are currently used as prognostic indexes [ 38 , 39 , 40 ].…”