The lymphocyte-to-monocyte ratio as a prognostic indicator in head and neck cancer: a systematic review and meta-analysis

Tham, Tristan; Olson, Caitlin; Khaymovich, Julian; Herman, Saori Wendy; Costantino, Peter D.

doi:10.1007/s00405-018-4972-x

Cited by 52 publications

(44 citation statements)

References 32 publications

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“…The association between LMR and prognostic factors were reported in head and neck cancers [12]. Ong et al reported that low pretreatment LMR indicated poor survival in patients with early tongue cancer [24].…”

Section: Discussionmentioning

confidence: 95%

“…One report suggested that leukocytes work differently in patients with cancer and those without [10]. The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-tolymphocyte ratio (PLR) are important hematological biomarkers and have been reported to be significant prognostic markers of head and neck cancer [11][12][13]. However, the results are controversial.…”

Section: Introductionmentioning

confidence: 99%

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Neutrophil-lymphocyte ratio associated with poor prognosis in oral cancer: a retrospective study

et al. 2020

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Background: Prognostic biomarkers provide essential information about a patient's overall outcome. However, existing biomarkers are limited in terms of either sample collection, such as requiring tissue specimens, or the process, such as prolonged time for analysis. In view of the need for convenient and non-invasive prognostic biomarkers for oral cancer, we aimed to investigate the prognostic values of neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio in patient survival. We also aimed to explore the associations of these ratios with the clinicopathologic characteristics of Japanese oral squamous cell carcinoma patients. Methods: This study was a non-randomized retrospective cohort study in a tertiary referral center. We included 433 patients (246 men, 187 women) who underwent radical surgery for oral cancers between January 2001 and December 2013. We evaluated various risk factors for poor prognosis including neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio with univariate and multivariate analyses. The disease-specific survival and overall survival rates of patients were compared among the factors and biomarkers. Results: In multivariable Cox proportional hazards analysis, high neutrophil-to-lymphocyte ratio (hazard ratio 2.87, 95% confidence interval 1.59-5.19, P < 0.001), moderately or poorly differentiated histology (hazard ratio 2.37, 95% confidence interval 1.32-4.25, P < 0.001), and extranodal extension (hazard ratio 1.95, 95% confidence interval 1.13-3.35, P = 0.016) were independent predictors of disease-specific survival. High neutrophil-to-lymphocyte ratio (hazard ratio 2.30, 95% confidence interval 1.42-3.72, P < 0.001), moderately or poorly differentiated (hazard ratio 1.72, 95% confidence interval 1.07-2.76, P = 0.025), and extranodal extension (hazard ratio 1.79, 95% confidence interval 1.13-2.84, P = 0.013) were independent predictors of overall survival. Conclusions: Neutrophil-to-lymphocyte ratio might be a potential independent prognostic factor in Japanese oral squamous cell carcinoma patients.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Neutrophil-lymphocyte ratio associated with poor prognosis in oral cancer: a retrospective study

et al. 2020

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“…The combination of these parameters has led to the analysis of possible biomarkers such as the relationship between the absolute count of neutrophils and lymphocytes, and the relationship between the absolute count of lymphocytes and monocytes, which in different studies and metanalyses have been shown to have prognostic capacity in various tumor models, including HNSCC …”

Section: Discussionmentioning

confidence: 99%

“…All these hematological parameters indicative of an inflammatory status and failure of the immune system have been combined in order to obtain new prognostic biomarkers, such as the neutrophil‐to‐lymphocyte ratio (NLR), the platelet‐to‐lymphocyte ratio (PLR), the lymphocyte‐to‐monocyte ratio (LMR), or the Glasgow Prognostic Score (GPS), calculated with the C‐reactive protein and albumin levels …”

Section: Introductionmentioning

confidence: 99%

Prognostic capacity of Systemic Inflammation Response Index (SIRI) in patients with head and neck squamous cell carcinoma

et al. 2019

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Background: Inflammation and immune evasion are associated with carcinogenesis. Systemic Inflammation Response Index (SIRI) has been proposed as a pretreatment peripheral blood biomarker. The aim of this study is to analyze its prognostic capacity in head and neck squamous cell carcinomas (HNSCC). Methods: We performed a retrospective study in 824 patients with HNSCC. SIRI was calculated by neutrophils*monocytes/lymphocytes. Using a recursivepartitioning analysis considering disease-specific survival (DSS) as dependent variable, three categories were defined according to SIRI value. Results: Males, patients with history of toxic consumption, oropharyngeal or hypopharyngeal tumors, and advanced tumors had a significantly higher SIRI value. As SIRI increased, a significant decrease in DSS was observed. In a multivariable analysis, SIRI was an independent predictor of DSS. Moreover, SIRI was a significant predictor of local, regional, and distant recurrence-free survival. Conclusions: SIRI has independent prognostic capacity in HNSCC. Patients with higher SIRI have a significant decrease in DSS.

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“…The pooled data demonstrated that elevated LMR was associated with significantly improved OS and DFS. 27 Pretreatment SIRI is a recently proposed factor that has been used to evaluate the clinical outcomes of cancer treatment. Patients with lower SIRI before surgical treatment showed a better OS than those patients with higher one in esophageal cancer.…”

Section: Discussionmentioning

confidence: 99%

<p>The Clinical Impacts of Pretreatment Peripheral Blood Ratio on Lymphocytes, Monocytes, and Neutrophils Among Patients with Laryngeal/Hypopharyngeal Cancer Treated by Chemoradiation/Radiation</p>

Chuang¹,

Tsai²,

Lin³

et al. 2020

CMAR

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This study aimed to investigate the clinical impacts of the pretreatment peripheral blood ratios of lymphocytes, monocytes and neutrophils among patients with hypopharyngeal cancer/laryngeal cancer. Patients and Methods: A total of 141 people with cases of hypopharyngeal cancer/ laryngeal cancer were enrolled to evaluate the clinical impacts of the systemic inflammation response index (SIRI), neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) in pretreatment blood among patients with laryngeal/hypopharyngeal cancer between January 2012 and December 2014. Results: Those patients with higher pretreatment LMR (>2.99) showed a significantly higher 5-year complete response rate (CR) (69% vs 31%) than those with lower LMR (≤2.99, p = 0.006). Additionally, those patients with lower pretreatment SIRI (<3.26) showed a significantly higher 5-year CR (90% vs 10%) than those with higher SIRI (≥3.26, p < 0.001). Patients with higher LMR had better 5-year overall survival (OS) (p = 0.01) and 5-year progression-free (PFS) (p = 0.005) rates than those with lower LMR in univariate analysis. Patients with lower SIRI had better 5-year OS (p < 0.001) and 5-year PFS (p < 0.001) than those with higher SIRI in univariate analysis. In the Cox regression analysis, SIRI (HR = 1.941, [95% CI: 1.223-3.081], p = 0.005) and N classification (HR = 2.203, [95% CI: 1.327-3.657], p = 0.002) were independent variables of 5-year OS. In addition, SIRI (HR= 2.127, [95% CI: 1.214-3.725], p = 0.008), T classification (HR = 2.18, [95% CI: 1.072-4.433], p = 0.031), and N classification (HR = 2.329, [95% CI: 1.395-3.889], p = 0.001) were independent variables of 5-year PFS. Conclusion: Pretreatment SIRI is superior to LMR in predicting treatment response and clinical outcomes among patients with laryngeal/hypopharyngeal cancer treated by CRT/RTO. SIRI may be adopted in the treatment of laryngeal/hypopharyngeal cancer by CRT/RTO.

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The lymphocyte-to-monocyte ratio as a prognostic indicator in head and neck cancer: a systematic review and meta-analysis

Cited by 52 publications

References 32 publications

Neutrophil-lymphocyte ratio associated with poor prognosis in oral cancer: a retrospective study

Neutrophil-lymphocyte ratio associated with poor prognosis in oral cancer: a retrospective study

Prognostic capacity of Systemic Inflammation Response Index (SIRI) in patients with head and neck squamous cell carcinoma

<p>The Clinical Impacts of Pretreatment Peripheral Blood Ratio on Lymphocytes, Monocytes, and Neutrophils Among Patients with Laryngeal/Hypopharyngeal Cancer Treated by Chemoradiation/Radiation</p>

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