Prognostic significance of the lymphocyte-to-monocyte ratio in bladder cancer undergoing radical cystectomy: A meta-analysis of 5638 individuals

Abstract

Introduction. A growing number of studies have explored the association between the pretreatment lymphocyte-to-monocyte ratio (LMR) and survival outcomes in various cancers. However, its prognostic significance on bladder cancer remains inconsistent. The aim of this meta-analysis was to evaluate the prognostic value of pretreatment LMR in bladder cancer. Methods. The MEDLINE, EMBASE, Cochrane Library, and CNKI databases were comprehensively searched for relevant studies. A meta-analysis of overall survival (OS), recurrence-free survival (RFS), or cancer-specific survival (CSS) clinicopathological features was conducted. Results. Nine studies containing 5,638 cancer patients were analyzed in this meta-analysis. Patients with high LMR tended to have favourable OS (HR: 0.63, 95% CI: 0.50-0.80, P < 0 001), RFS (HR: 0.59, 95% CI: 0.38-0.91, P = 0 017), and CSS (HR: 0.76, 95% CI: 0.70-0.83, P < 0 001). Moreover, low LMR was highly correlated with age (≥60), differentiation (low), T stage (III-IV), lymph node metastasis (yes), and concomitant Cis (yes). Conclusion. Pretreatment LMR might be a useful predictor of survival outcomes in patients with bladder cancer.