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SYSTEMATIC REVIEW article

Front. Oncol.
Sec. Gastrointestinal Cancers: Colorectal Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1394154
This article is part of the Research Topic Precision Therapy in Colorectal Cancer View all 7 articles

The prognostic utility of the ratio of lymphocyte to monocyte in patients with metastatic colorectal cancer: a systematic review and meta-analysis

Provisionally accepted
Pingping Mei Pingping Mei 1*Lu Lin Lu Lin 2*Xiutian Guo Xiutian Guo 3*
  • 1 Shanghai University of Traditional Chinese Medicine, Shanghai, China
  • 2 Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
  • 3 Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China

The final, formatted version of the article will be published soon.

    Background Although advancements in treatment have resulted in improved overall outcomes for patients diagnosed with colorectal cancer, the prognosis remains unfavorable for individuals with metastatic colorectal cancer (mCRC). The association between lymphocyte/monocyte ratio (LMR) and clinical outcomes in mCRC patients is a subject of controversy. To systematically evaluate the correlation between LMR and prognostic factors in individuals with mCRC, we conducted this meta-analysis.The databases PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for all relevant studies from their inception until October 26, 2024.Study selection was conducted based on predetermined inclusion and exclusion criteria. The primary outcomes of interest included prognosis measures such as overall survival (OS), progression-free survival (PFS), disease-free survival (DFS), and cancer-specific survival (CSS) in patients with metastatic colorectal cancer. Random-effects models or fixed-effects models were used to determine the pooled risk ratio (HR) and corresponding 95% confidence interval (CI) for each outcome indicator. Additionally, the pooled odds ratio (OR) and its corresponding 95% CI were calculated for LMR and clinicopathological characteristics.Fourteen studies involving 3,089 patients were included in the analysis. The pooled analysis found that high LMR was correlated with better OS (HR: 0.55, 95% CI: 0.49-0.62, p ＜ 0.00001), PFS (HR: 0.68, 95% CI: 0.57-0.81, p ＜ 0.0001) and CSS(HR: 0.55, 95% CI: 0.32-0.95, p=0.03),The prognostic value of high LMR values for DFS(HR: 0.93, 95% CI: 0.78-1.12, p=0.46) in patients with metastatic rectal cancer was not found to be significant.We performed subgroup analyses based on study characteristics to confirm the robustness of our findings. Further clinicopathological analysis showed no significant difference between patients with elevated LMR and those without elevated LMR.In conclusion, the results demonstrate a robust correlation between elevated LMR levels and a favorable prognosis in terms of overall survival (OS), progression-free survival (PFS), and cancer-specific survival (CSS) among patients diagnosed with metastatic colorectal cancer. However, further high-quality prospective studies are warranted to validate our findings since the majority of current investigations have relied on retrospective study designs.

    Keywords: Lymphocyte-to-monocyte ratio, Metastatic colorectal cancer, Survival, prognosis, Meta-analysis

    Received: 01 Mar 2024; Accepted: 07 Jan 2025.

    Copyright: © 2025 Mei, Lin and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Pingping Mei, Shanghai University of Traditional Chinese Medicine, Shanghai, China
    Lu Lin, Shaanxi University of Chinese Medicine, Xianyang, 712046, Shaanxi, China
    Xiutian Guo, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, 200071, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.