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Published in: European Archives of Oto-Rhino-Laryngology 7/2018

01-07-2018 | Review Article

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

Authors: Tristan Tham, Caitlin Olson, Julian Khaymovich, Saori Wendy Herman, Peter David Costantino

Published in: European Archives of Oto-Rhino-Laryngology | Issue 7/2018

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Abstract

Purpose

The aim of this systematic review and meta-analysis was to investigate the relationship between the pre-treatment lymphocyte-to-monocyte ratio (LMR) and prognosis in HNC.

Methods

PubMed (via the Web), Embase, Scopus, and the Cochrane Library were searched. A systematic review and meta-analysis was done to generate the pooled hazard ratios (HR) for overall survival (OS) and disease-free survival (DFS).

Results

Our analysis included the results of 4260 patients in seven cohorts. The pooled data demonstrated that an elevated LMR was associated with significantly improved OS (HR 0.5; 95% CI 0.44–0.57), and DFS (HR 0.70; 95% CI 0.62–0.80). Of note, there was no detectable heterogeneity in either OS (I2 = 0%) or DFS (I2 = 0%).

Conclusions

An elevated LMR may be an indicator of favorable prognosis in HNC. However, our results should be interpreted with some degree of caution due to the retrospective nature of cohort studies. Further research with high-quality prospective studies is needed to confirm the effect of LMR in HNC prognosis.
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Literature
1.
3.
go back to reference O’callaghan DS, O’donnell D, O’connell F, O’byrne KJ (2010) The role of inflammation in the pathogenesis of non-small cell lung cancer. J Thorac Oncol 5(12):2024–2036CrossRefPubMed O’callaghan DS, O’donnell D, O’connell F, O’byrne KJ (2010) The role of inflammation in the pathogenesis of non-small cell lung cancer. J Thorac Oncol 5(12):2024–2036CrossRefPubMed
4.
go back to reference Aggarwal BB, Vijayalekshmi R, Sung B (2009) Targeting inflammatory pathways for prevention and therapy of cancer: short-term friend, long-term foe. Clin Cancer Res 15(2):425–30CrossRefPubMed Aggarwal BB, Vijayalekshmi R, Sung B (2009) Targeting inflammatory pathways for prevention and therapy of cancer: short-term friend, long-term foe. Clin Cancer Res 15(2):425–30CrossRefPubMed
5.
go back to reference Teng J-J, Zhang J, Zhang T-Y, Zhang S, Li B-S (2016) Prognostic value of peripheral blood lymphocyte-to-monocyte ratio in patients with solid tumors: a meta-analysis. Onco Targets Ther 9:37PubMed Teng J-J, Zhang J, Zhang T-Y, Zhang S, Li B-S (2016) Prognostic value of peripheral blood lymphocyte-to-monocyte ratio in patients with solid tumors: a meta-analysis. Onco Targets Ther 9:37PubMed
6.
go back to reference Su L, Zhang M, Zhang W, Cai C, Hong J (2017) Pretreatment hematologic markers as prognostic factors in patients with nasopharyngeal carcinoma: a systematic review and meta-analysis. Medicine 96(11):e6364CrossRefPubMedPubMedCentral Su L, Zhang M, Zhang W, Cai C, Hong J (2017) Pretreatment hematologic markers as prognostic factors in patients with nasopharyngeal carcinoma: a systematic review and meta-analysis. Medicine 96(11):e6364CrossRefPubMedPubMedCentral
7.
go back to reference Macaskill P, Gatsonis C, Deeks J, Harbord R, Takwoingi Y. Cochrane handbook for systematic reviews of diagnostic test accuracy. Version 09 0 London: The Cochrane Collaboration. 2010 Macaskill P, Gatsonis C, Deeks J, Harbord R, Takwoingi Y. Cochrane handbook for systematic reviews of diagnostic test accuracy. Version 09 0 London: The Cochrane Collaboration. 2010
8.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097CrossRefPubMedPubMedCentral Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097CrossRefPubMedPubMedCentral
9.
go back to reference Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA 283(15):2008–2012CrossRefPubMed Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA 283(15):2008–2012CrossRefPubMed
11.
go back to reference Hayden JA, van der Windt DA, Cartwright JL, Côté P, Bombardier C (2013) Assessing bias in studies of prognostic factors. Ann Intern Med 158(4):280–286CrossRefPubMed Hayden JA, van der Windt DA, Cartwright JL, Côté P, Bombardier C (2013) Assessing bias in studies of prognostic factors. Ann Intern Med 158(4):280–286CrossRefPubMed
12.
go back to reference Hsueh C, Tao L, Zhang M et al (2017) The prognostic value of preoperative neutrophils, platelets, lymphocytes, monocytes and calculated ratios in patients with laryngeal squamous cell cancer. Oncotarget 8(36):60514CrossRefPubMedPubMedCentral Hsueh C, Tao L, Zhang M et al (2017) The prognostic value of preoperative neutrophils, platelets, lymphocytes, monocytes and calculated ratios in patients with laryngeal squamous cell cancer. Oncotarget 8(36):60514CrossRefPubMedPubMedCentral
13.
go back to reference Szekely G, Remenar E, Kasler M, Bodrog A, Gundy S (2001) Validity of chromosome analysis and bleomycin sensitivity assay in the prevention of head and neck cancer in Hungary. Orv Hetil 142(12):611–616PubMed Szekely G, Remenar E, Kasler M, Bodrog A, Gundy S (2001) Validity of chromosome analysis and bleomycin sensitivity assay in the prevention of head and neck cancer in Hungary. Orv Hetil 142(12):611–616PubMed
14.
go back to reference Rosenthal R (1979) The file drawer problem and tolerance for null results. Psychol Bull 86(3):638CrossRef Rosenthal R (1979) The file drawer problem and tolerance for null results. Psychol Bull 86(3):638CrossRef
15.
go back to reference Suurmond R, Rhee H, Hak T (2017) Introduction, comparison, and validation of Meta‐Essentials: a free and simple tool for meta‐analysis. Res Synth Methods 8(4):537–553CrossRef Suurmond R, Rhee H, Hak T (2017) Introduction, comparison, and validation of Meta‐Essentials: a free and simple tool for meta‐analysis. Res Synth Methods 8(4):537–553CrossRef
16.
go back to reference Li J, Jiang R, Liu W-S et al (2013) A large cohort study reveals the association of elevated peripheral blood lymphocyte-to-monocyte ratio with favorable prognosis in nasopharyngeal carcinoma. PLoS One 8(12):e83069CrossRefPubMedPubMedCentral Li J, Jiang R, Liu W-S et al (2013) A large cohort study reveals the association of elevated peripheral blood lymphocyte-to-monocyte ratio with favorable prognosis in nasopharyngeal carcinoma. PLoS One 8(12):e83069CrossRefPubMedPubMedCentral
17.
go back to reference Li MX, Liu XM, Zhang XF et al (2014) Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: a systematic review and meta-analysis. Int J Cancer 134(10):2403–2413CrossRefPubMed Li MX, Liu XM, Zhang XF et al (2014) Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: a systematic review and meta-analysis. Int J Cancer 134(10):2403–2413CrossRefPubMed
18.
go back to reference Jiang R, Cai X-Y, Yang Z-H et al (2015) Elevated peripheral blood lymphocyte-to-monocyte ratio predicts a favorable prognosis in the patients with metastatic nasopharyngeal carcinoma. Chin J Cancer 34(3):23CrossRefPubMedCentral Jiang R, Cai X-Y, Yang Z-H et al (2015) Elevated peripheral blood lymphocyte-to-monocyte ratio predicts a favorable prognosis in the patients with metastatic nasopharyngeal carcinoma. Chin J Cancer 34(3):23CrossRefPubMedCentral
19.
go back to reference Kano S, Homma A, Hatakeyama H et al (2017) Pretreatment lymphocyte-to-monocyte ratio as an independent prognostic factor for head and neck cancer. Head Neck 39(2):247–53CrossRefPubMed Kano S, Homma A, Hatakeyama H et al (2017) Pretreatment lymphocyte-to-monocyte ratio as an independent prognostic factor for head and neck cancer. Head Neck 39(2):247–53CrossRefPubMed
20.
go back to reference Ong HS, Gokavarapu S, Wang LZ, Tian Z, Zhang CP (2016) Low pretreatment lymphocyte–monocyte ratio and high platelet–lymphocyte ratio indicate poor cancer outcome in early tongue cancer. J Oral Maxillofac Surg 75(8):1762–1774 Ong HS, Gokavarapu S, Wang LZ, Tian Z, Zhang CP (2016) Low pretreatment lymphocyte–monocyte ratio and high platelet–lymphocyte ratio indicate poor cancer outcome in early tongue cancer. J Oral Maxillofac Surg 75(8):1762–1774
21.
go back to reference Lin G-N, Peng J-W, Liu D-Y et al (2014) Increased lymphocyte to monocyte ratio is associated with better prognosis in patients with newly diagnosed metastatic nasopharyngeal carcinoma receiving chemotherapy. Tumor Biol 35(11):10849–10854CrossRef Lin G-N, Peng J-W, Liu D-Y et al (2014) Increased lymphocyte to monocyte ratio is associated with better prognosis in patients with newly diagnosed metastatic nasopharyngeal carcinoma receiving chemotherapy. Tumor Biol 35(11):10849–10854CrossRef
22.
go back to reference Li XH, Chang H, Xu BQ et al (2016) An inflammatory biomarker-based nomogram to predict prognosis of patients with nasopharyngeal carcinoma: an analysis of a prospective study. Cancer Med 6(1):310–319 Li XH, Chang H, Xu BQ et al (2016) An inflammatory biomarker-based nomogram to predict prognosis of patients with nasopharyngeal carcinoma: an analysis of a prospective study. Cancer Med 6(1):310–319
23.
go back to reference Ryan R; Cochrane Consumers and Communication Review Group (2016) Heterogeneity and subgroup analyses in cochrane consumers and communication group reviews: planning the analysis at protocol stage. http://cccrg.cochrane.org Ryan R; Cochrane Consumers and Communication Review Group (2016) Heterogeneity and subgroup analyses in cochrane consumers and communication group reviews: planning the analysis at protocol stage. http://​cccrg.​cochrane.​org
24.
go back to reference Lu H, Ouyang W, Huang C (2006) Inflammation, a key event in cancer development. Mol Cancer Res 4(4):221–33CrossRefPubMed Lu H, Ouyang W, Huang C (2006) Inflammation, a key event in cancer development. Mol Cancer Res 4(4):221–33CrossRefPubMed
25.
go back to reference Gooden MJ, de Bock GH, Leffers N, Daemen T, Nijman HW (2011) The prognostic influence of tumour-infiltrating lymphocytes in cancer: a systematic review with meta-analysis. Br J Cancer 105(1):93–103CrossRefPubMedPubMedCentral Gooden MJ, de Bock GH, Leffers N, Daemen T, Nijman HW (2011) The prognostic influence of tumour-infiltrating lymphocytes in cancer: a systematic review with meta-analysis. Br J Cancer 105(1):93–103CrossRefPubMedPubMedCentral
26.
go back to reference Pollard JW (2004) Tumour-educated macrophages promote tumour progression and metastasis. Nat Rev Cancer 4(1):71–8CrossRefPubMed Pollard JW (2004) Tumour-educated macrophages promote tumour progression and metastasis. Nat Rev Cancer 4(1):71–8CrossRefPubMed
27.
go back to reference Xiong M, Elson G, Legarda D, Leibovich SJ (1998) Production of vascular endothelial growth factor by murine macrophages: regulation by hypoxia, lactate, and the inducible nitric oxide synthase pathway. Am J Pathol 153(2):587–98CrossRefPubMedPubMedCentral Xiong M, Elson G, Legarda D, Leibovich SJ (1998) Production of vascular endothelial growth factor by murine macrophages: regulation by hypoxia, lactate, and the inducible nitric oxide synthase pathway. Am J Pathol 153(2):587–98CrossRefPubMedPubMedCentral
28.
go back to reference Lin G-N, Peng J-W, Xiao J-j, Liu D-Y, Xia Z-J (2014) Prognostic impact of circulating monocytes and lymphocyte-to-monocyte ratio on previously untreated metastatic non-small cell lung cancer patients receiving platinum-based doublet. Med Oncol 31(7):70CrossRefPubMed Lin G-N, Peng J-W, Xiao J-j, Liu D-Y, Xia Z-J (2014) Prognostic impact of circulating monocytes and lymphocyte-to-monocyte ratio on previously untreated metastatic non-small cell lung cancer patients receiving platinum-based doublet. Med Oncol 31(7):70CrossRefPubMed
29.
go back to reference Zhang G-M, Zhu Y, Luo L et al (2015) Preoperative lymphocyte-monocyte and platelet-lymphocyte ratios as predictors of overall survival in patients with bladder cancer undergoing radical cystectomy. Tumor Biol 36(11):8537–8543CrossRef Zhang G-M, Zhu Y, Luo L et al (2015) Preoperative lymphocyte-monocyte and platelet-lymphocyte ratios as predictors of overall survival in patients with bladder cancer undergoing radical cystectomy. Tumor Biol 36(11):8537–8543CrossRef
30.
go back to reference Qi Q, Geng Y, Sun M, Wang P, Chen Z (2015) Clinical implications of systemic inflammatory response markers as independent prognostic factors for advanced pancreatic cancer. Pancreatology 15(2):145–50CrossRefPubMed Qi Q, Geng Y, Sun M, Wang P, Chen Z (2015) Clinical implications of systemic inflammatory response markers as independent prognostic factors for advanced pancreatic cancer. Pancreatology 15(2):145–50CrossRefPubMed
31.
go back to reference Szkandera J, Gerger A, Liegl-Atzwanger B et al (2014) The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas. Int J Cancer 135(2):362–70CrossRefPubMed Szkandera J, Gerger A, Liegl-Atzwanger B et al (2014) The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas. Int J Cancer 135(2):362–70CrossRefPubMed
32.
go back to reference Templeton AJ, McNamara MG, Šeruga B et al (2014) Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 106(6):dju124CrossRefPubMed Templeton AJ, McNamara MG, Šeruga B et al (2014) Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 106(6):dju124CrossRefPubMed
33.
go back to reference McMillan DC (2013) The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer. Cancer Treat Rev 39(5):534–40CrossRefPubMed McMillan DC (2013) The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer. Cancer Treat Rev 39(5):534–40CrossRefPubMed
Metadata
Title
The lymphocyte-to-monocyte ratio as a prognostic indicator in head and neck cancer: a systematic review and meta-analysis
Authors
Tristan Tham
Caitlin Olson
Julian Khaymovich
Saori Wendy Herman
Peter David Costantino
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 7/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-4972-x

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