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Pretreatment lymphocyte-to-monocyte ratio as a predictor of survival among patients with ovarian cancer: a meta-analysis

Authors Gao XP, Liu YH, Liu ZY, Wang LJ, Jing CX, Zhu S, Zeng FF

Received 22 August 2018

Accepted for publication 7 November 2018

Published 27 February 2019 Volume 2019:11 Pages 1907—1920


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Rituraj Purohit

Xu-ping Gao,1,* Yan-hua Liu,2,* Ze-ying Liu,1 Li-jun Wang,3 Chun-xia Jing,1 Sui Zhu,4 Fang-fang Zeng1

1Department of Epidemiology, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China; 2Department of Nutrition, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China; 3Department of Nutrition, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China; 4Department of Medical Statistics, School of Medicine, Jinan University, Guangzhou 510632, Guangdong, China

*These authors contributed equally to this work

Introduction: In this meta-analysis, we analyzed retrospective cohort studies that assessed the prognostic potential of the pretreatment lymphocyte-to-monocyte ratio (LMR) among patients with ovarian cancer (OC).
Materials and methods: We comprehensively searched electronic databases, including PubMed and Embase, from inception through October 2018. A random-effects model was used to calculate pooled HRs and their 95% CIs for overall survival (OS) and progression-free survival (PFS). The low LMR group was treated as the reference group.
Results: Twelve studies, including 3,346 OC cases at baseline, were included. Overall, our results indicated that LMR was positively associated with both OS (HR: 1.85, 95% CI: 1.50–2.28, P<0.001; I2=76.5%) and PFS (HR: 1.70, 95% CI: 1.49–1.94, P<0.001; I2=24.4%) among OC patients. Stratified analyses indicated that, for OS, the LMR’s protective effect was more evident in studies conducted among younger patients (<55 years) than in those conducted among older patients (≥55 years; P for interaction =0.017), which was confirmed by meta-regression
analysis (P=0.004).
Conclusion: This study suggested that a higher pretreatment LMR level was associated with a favorable prognosis among OC patients. Future large-scale prospective clinical trials are needed to confirm the prognostic value of LMR among OC patients.

Keywords: ovarian cancer, lymphocyte-to-monocyte ratio, prognosis, meta-analysis

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