SynthesisWorld journal of surgical oncology2026
Prognostic value of the immune-inflammatory indices in osteosarcoma: a systematic review and meta-analysis.
Synthesis in World journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
backgroundSystemic inflammation plays an important role in driving tumor progression. Several inflammation-related indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and the systemic immune-inflammation index (SII), have been proposed as prognostic biomarkers across various cancers. Nevertheless, their prognostic utility in osteosarcoma remains uncertain. This systematic review and meta-analysis was conducted to evaluate the associations between these indices and survival outcomes in patients with osteosarcoma.
methodsWe conducted a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library for articles published through 30 June 2025 that assessed the relationship between pretreatment NLR, PLR, LMR, or SII and osteosarcoma patient overall survival (OS), progression-free survival (PFS), and/or event-free survival (EFS). A random-effects model was used to pool summary hazard ratios (HRs) with 95% confidence intervals (CIs). Subgroup and sensitivity analyses were also conducted, along with publication-bias assessments.
resultsA total of 22 studies incorporating 57 cohort comparisons met the inclusion criteria for this meta-analysis. High NLR values were significantly associated with worse OS (HR = 1.52; 95% CI, 1.29-1.78; p < 0.0001). Similarly, high SII values were correlated with reduced OS (HR = 1.84; 95% CI, 1.05-3.21; p = 0.03), and high PLR values predicted poorer OS (HR = 1.21; 95% CI, 1.07-1.37; p = 0.002). In contrast, LMR was not significantly associated with OS (HR = 1.13; 95% CI, 0.91-1.39; p = 0.26). Of the evaluated progression endpoints, only NLR was significantly associated with shorter PFS (HR = 1.84; 95% CI, 1.04-3.25; p = 0.03).
conclusionsPretreatment immune-inflammatory indices may have prognostic relevance in osteosarcoma, with NLR showing the most consistent association with adverse survival outcomes. Although PLR and SII were associated with poorer OS in pooled analyses, these findings should be interpreted cautiously because of substantial heterogeneity, limited study numbers, potential small-study effects, and sensitivity instability, particularly for SII. Large-scale prospective multicenter studies with standardized cut-off values are required before these indices can be incorporated into routine clinical prognostic evaluation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.