Abstract
In recent years, several studies have reported monocyte lymphocyte ratio (MLR) to predict prognosis in various tumors. Our study was performed to evaluate the association between preoperative MLR between prognostic variables in urothelial carcinoma patients. Systematic literature search was conducted in PubMed, Embase, Web of science. The correlation between preoperative MLR and overall survival (OS), cancer specific survival (CSS), disease free survival (DFS)/relapse free survival (RFS), progression free survival(PFS) was evaluated in urothelial carcinoma patients. Meanwhile, the association between MLR and clinicopathological characteristics was assessed. Finally, 12 comparative studies comprising a total of 6209 patients were included for pooled analysis. The hazard ratios (HRs), odds ratios (ORs)and 95% confidence intervals (CIs) were further analyzed as effect measures. The pooled results demonstrated that elevated preoperative MLR indicated unfavorable OS (HR = 1.29, 95%CI = 1.18-1.39, I2 = 33.6%), DFS/RFS (HR = 1.42, 95%CI = 1.30–1.55, I2 = 0.0%) and CSS (HR = 1.41, 95%CI = 1.29–1.52, I2 = 0.0%). Moreover, the pooled results also suggested that elevated preoperative MLR was correlated with high tumor stage (OR = 1.22, 95%CI = 1.07–1.37, I2 = 0.0%) in urothelial carcinoma patients. No significant association was found between preoperative MLR and PFS in upper urinary tract urothelial carcinoma (UUTUC) patients. Collectively, elevated preoperative MLR predicted poor prognosis in urothelial carcinoma and have the potential to be a feasible and cost-effective prognostic predictor for management of urothelial carcinoma.
Highlights
Urothelial carcinoma is defined as the malignancy derived from the mucosal surface of urinary system
58 full-text studies were evaluated for eligibility, and 46 studies were further excluded for not focusing on preoperative monocyte lymphocyte ratio (MLR) or without sufficient data to extract the hazard ratios (HRs) and 95%confidence intervals (CIs) for prognostic variables
Urothelial carcinoma was the most common malignant tumors in urinary system, which derived from the lining surface epithelium termed as “urothelium” with the same embryologic origin[1]
Summary
Urothelial carcinoma is defined as the malignancy derived from the mucosal surface of urinary system. Since 2014, emerging studies have reported the preoperative MLR as a potential predictor in UCB or UUTUC patients[16,17,18], and Yoshida’s study www.nature.com/scientificreports/. Reported preoperative MLR could be a better predictor in UCB patients, comparing with NLR19. The role of preoperative MLR is still in controversy for urothelial malignancies, and needs to be validated due to the inevitable discrepancy among the studies. We performed this pooled analysis to assess the potential impact of preoperative MLR in patients with urothelial malignancies. Relationships between preoperative MLR and the clinicopathological characteristics was assessed
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