Prognostic value of lymphocyte to monocyte ratio for the patients with bladder cancer: a systematic review and meta-analysis.

Abstract

<h4>Objectives</h4>To provide a meta-analysis evaluating the predictive value of lymphocyte to monocyte ratio (LMR) in the efficacy and prognosis of bladder cancer patients.<h4>Methods</h4>Web of Science, Embase, Cochrane, and PubMed for literature searching up to November 2024 to identify research assessing the prognostic significance of LMR in bladder cancer patients. Outcomes included overall survival (OS), relapse-free survival (RFS), progression-free survival (PFS), and cancer-specific survival (CSS). Hazard ratios (HR) and 95% confidence intervals (CI) were used for data pooling of survival variables. In addition, for investigating potential heterogeneity sources and assessing the stability of the findings, sensitivity and subgroup analysis were performed. Review Manger 5.4 and STATA 15.1 were used to analyze.<h4>Results</h4>Seventeen studies with 7,968 patients with bladder cancer included. The results indicated a notably shorter OS (HR: 1.56; 95% CI: 1.29, 1.89; <i>P</i> <0.00001), RFS (HR: 1.74; 95% CI: 1.27, 2.36; <i>P</i> = 0.0005), PFS (HR: 2.04; 95% CI: 1.58, 2.64; <i>P</i><0.00001) and CSS (HR: 1.24; 95% CI: 1.01, 1.52; <i>P</i> = 0.04) in patients with low LMR compared to those with high LMR. Furthermore, subgroup analysis of OS found that study design, region, and age were the main factors affecting the correlation between LMR and OS.<h4>Conclusions</h4>LMR can effectively predict the survival and recurrence risk of bladder cancer patients, helpingin the improvement of their prognosis. Future research should focus on large-scale, multicenter prospective cohort studies are still required in the future to evaluate the predictive value of LMR bladder cancer patients.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024618066 PROSPERO (CRD42024618066).