Prognostic value of lymphocyte to monocyte ratio for metastatic renal cell carcinoma: a systematic review and meta-analysis
- 1Department of Urology and Thoracic Surgery, West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan China
- 2Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
Abstract
Objective: To systematically evaluate the prognostic value of lymphocyte-to-monocyte ratio (LMR) for the prognosis of patients with metastatic renal cell carcinoma (mRCC).
Methods: This systematic review and meta-analysis followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251246337). Relevant literature up to November 2025 was systematically searched in PubMed, Embase, Web of Science, and Cochrane Library. Observational studies assessing the relationship between LMR and overall survival (OS) and progression-free survival (PFS) in mRCC patients were included. Two researchers independently screened the literature, extracted data, and assessed the quality using the Newcastle-Ottawa Health Scale (NOS). Pooled hazard ratios (HR) and their 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic, and sensitivity analysis and Egger’s test were performed to assess publication bias.
Results: A total of 11 studies involving 1763 patients with mRCC were included. Meta-analysis results showed that lower LMR was significantly associated with shorter OS (HR = 1.64, 95% CI: 1.30–2.07, P < 0.0001) and shorter PFS (HR = 1.33, 95% CI: 1.14–1.56, P = 0.0003). OS analysis showed high heterogeneity (I² = 82%), with sensitivity analysis suggesting the Barua 2019 study was the primary source; while PFS heterogeneity was low (I² = 15%). Egger’s test indicated publication bias in OS (P = 0.04), but the association remained significant after trimming and complement correction (corrected HR = 1.44, 95% CI: 1.10–1.89), indicating robust results.
Conclusion: LMR is significantly associated with OS and PFS in patients with mRCC, and low LMR indicates poor prognosis. Although OS is heterogeneous, the results are robust. As an economical and readily available inflammatory marker, LMR can help with risk stratification and individualized treatment decisions in mRCC, but its standardization of threshold values and its role in assessing prognosis still require further validation through prospective studies.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12885-026-16689-6.
Related
- Prognostic value of neutrophil-to-lymphocyte ratio in nasopharyngeal carcinoma: a systematic review and meta-analysis of 30 cohorts through June 30, 2026
- Prognostic value of the preoperative C-reactive protein-to-lymphocyte ratio in patients with non-metastatic clear cell renal cell carcinoma
- Prognostic value of neutrophil-to-lymphocyte ratio in renal cell carcinoma: an updated systematic review and meta-analysis.
- Prognostic value of the hemoglobin, albumin, lymphocyte, and platelet score in nonmetastatic renal cell carcinoma after nephrectomy
- Prognostic value of the neutrophil-to-lymphocyte ratio in patients with colorectal cancer undergoing chemotherapy: a systematic review and meta-analysis
BibTeX
@article{zhang2026prognostic,
title = {{Prognostic value of lymphocyte to monocyte ratio for metastatic renal cell carcinoma: a systematic review and meta-analysis}},
author = {Xingbao Zhang and Yao Wu and Zhongyi Zeng},
journal = {BMC Cancer},
year = {2026},
month = aug,
doi = {10.1186/s12885-026-16689-6},
url = {https://doi.org/10.1186/s12885-026-16689-6},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Prognostic value of lymphocyte to monocyte ratio for metastatic renal cell carcinoma: a systematic review and meta-analysis
AU - Xingbao Zhang
AU - Yao Wu
AU - Zhongyi Zeng
PY - 2026
DA - 2026/08/07
JO - BMC Cancer
DO - 10.1186/s12885-026-16689-6
UR - https://doi.org/10.1186/s12885-026-16689-6
AB - Objective: To systematically evaluate the prognostic value of lymphocyte-to-monocyte ratio (LMR) for the prognosis of patients with metastatic renal cell carcinoma (mRCC). Methods: This systematic review and meta-analysis followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251246337). Relevant literature up to November 2025 was systematically searched in PubMed, Embase, Web of Science, and Cochrane Library. Observational studies assessing the relationship between LMR and overall survival (OS) and progression-free survival (PFS) in mRCC patients were included. Two researchers independently screened the literature, extracted data, and assessed the quality using the Newcastle-Ottawa Health Scale (NOS). Pooled hazard ratios (HR) and their 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic, and sensitivity analysis and Egger’s test were performed to assess publication bias. Results: A total of 11 studies involving 1763 patients with mRCC were included. Meta-analysis results showed that lower LMR was significantly associated with shorter OS (HR = 1.64, 95% CI: 1.30–2.07, P < 0.0001) and shorter PFS (HR = 1.33, 95% CI: 1.14–1.56, P = 0.0003). OS analysis showed high heterogeneity (I² = 82%), with sensitivity analysis suggesting the Barua 2019 study was the primary source; while PFS heterogeneity was low (I² = 15%). Egger’s test indicated publication bias in OS (P = 0.04), but the association remained significant after trimming and complement correction (corrected HR = 1.44, 95% CI: 1.10–1.89), indicating robust results. Conclusion: LMR is significantly associated with OS and PFS in patients with mRCC, and low LMR indicates poor prognosis. Although OS is heterogeneous, the results are robust. As an economical and readily available inflammatory marker, LMR can help with risk stratification and individualized treatment decisions in mRCC, but its standardization of threshold values and its role in assessing prognosis still require further validation through prospective studies. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12885-026-16689-6.
SN - 1471-2407
ER -