Observational studyBMC cancer2023
Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation.
Observational study in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Prognostic associations of systemic inflammation response index (SIRI) in patients with head and neck cancer: a systematic review and meta-analysis.Oral oncology · 2026Pooled it
- Efficacy of the Geriatric Nutritional Risk Index for Predicting Overall Survival in Patients with Head and Neck Cancer: A Meta-Analysis.Nutrients · 2023Pooled it
- Higher pre-treatment lymphocyte-to-monocyte ratio predicts better tumor shrinkage after external beam radiotherapy in locally advanced cervical cancer.Frontiers in oncology · 2026Article
- Outcomes and prognostic markers in locally advanced head and neck squamous cell carcinoma underwent chemoradiotherapy.Discover oncology · 2025Article
- Article
- Safety and efficacy of a STAT3-targeted cyclic oligonucleotide: From murine models to a phase 1 clinical trial in pet cats with oral cancer.Cancer cell · 2025Article
- Prognostic value of pretreatment peripheral blood biomarkers in patients with head and neck squamous cell carcinoma treated with chemo/bioradiotherapy.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Article
- Prognostic utility of the C-reactive protein-albumin-lymphocyte (CALLY) index in metastatic renal cell carcinoma.BMC cancer · 2025Article
- Analysis of Patients with Glioblastoma Treated with Standard 6-Week Chemoradiation Followed by Temozolomide: Treatment Outcomes and Prognostic Factors.Medicina (Kaunas, Lithuania) · 2025Article
- Predictive model based on blood cell analysis and coagulation function indicators for neuroblastic tumors staging diagnosis.Frontiers in oncology · 2025Article
- Utility of lymphocyte-to-monocyte ratio and pretreatment tooth extraction in intra-arterial chemoradiotherapy for oral cancer to prevent osteoradionecrosis of the jaw.Scientific reports · 2024Article
Corrections and comments
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Authors and funding
18 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundGiven the role of systematic inflammation in cancer progression, lymphocyte-monocyte ratio (LMR) from peripheral blood has been suggested as a biomarker to assess the extent of inflammation in several solid malignancies. However, the role of LMR as a prognostic factor in head and neck cancer was unclear in several meta-analyses, and there is a paucity of literature including patients in North America. We performed an observational cohort study to evaluate the association of LMR with survival outcomes in North American patients with head and neck cancer.
methodsA single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent definitive chemoradiation from June 2007 to April 2021 at the Roswell Park Comprehensive Cancer Center. Primary endpoints were overall survival (OS) and cancer-specific survival (CSS). The association of LMR with OS and CSS was examined using nonlinear Cox proportional hazard model using restricted cubic splines (RCS). Cox multivariable analysis (MVA) and Kaplan-Meier method were used to analyze OS and CSS. Pre-radiation LMR was then stratified into high and low based on its median value. Propensity scored matching was used to reduce the selection bias.
resultsA total of 476 patients met our criteria. Median follow up was 45.3 months (interquartile range 22.8-74.0). The nonlinear Cox regression model showed that low LMR was associated with worse OS and CSS in a continuous fashion without plateau for both OS and CSS. On Cox MVA, higher LMR as a continuous variable was associated with improved OS (adjusted hazard ratio [aHR] 0,90, 95% confidence interval [CI] 0.82-0.99, p = 0.03) and CSS (aHR 0.83, 95% CI 0.72-0.95, p = 0.009). The median value of LMR was 3.8. After propensity score matching, a total of 186 pairs were matched. Lower LMR than 3.8 remained to be associated with worse OS (HR 1.59, 95% CI 1.12-2.26, p = 0.009) and CSS (HR 1.68, 95% CI 1.08-2.63, p = 0.02).
conclusionLow LMR, both as a continuous variable and dichotomized variable, was associated with worse OS and CSS. Further studies would be warranted to evaluate the role of such prognostic marker to tailor interventions.
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