Prognostic Significance of Lymphocyte-to-Monocyte Ratio in Patients with Osteosarcoma: A Meta-Analysis

Abstract

Objective: To evaluate the correlation between the lymphocyte-to-monocyte ratio (LMR) and overall survival (OS) in patients with osteosarcoma. Methods: Eligible articles were selected from PubMed, Embase, the Cochrane Library, Web of Science, Wanfang Data, China National Knowledge Infrastructure, and the China Science and Technology journal databases from inception to September 8, 2022. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the correlation between LMR and OS in osteosarcoma. Subgroup, sensitivity, and publication bias analyses were performed. Results: Seven studies involving 1013 patients were extracted. LMR and OS of osteosarcoma showed a significant negative correlation (HR = 0.55;95% CI: 0.44 to 0.69;p < 0.001). Subgroup analyses showed that the results of the following groups were consistent with the merged meta-analysis results: China, Turkey, with or without a multivariate analysis, high or moderate quality assessment, male sex ≥50% or <50%, follow-up time ≤24 or <24 months, surgery, and surgery or chemotherapy (all p for subgroup effects <0.05). The sensitivity analysis showed that the combined results were stable. No significant publication bias was observed in the included studies. Conclusions: Our results indicated that increased LMR was significantly associated with decreased OS in patients with osteosarcoma. These findings may contribute to the prognostic evaluation and development of immunotherapy strategies for osteosarcoma.