European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 7, pp 1663–1670 | Cite as

The lymphocyte-to-monocyte ratio as a prognostic indicator in head and neck cancer: a systematic review and meta-analysis

  • Tristan Tham
  • Caitlin Olson
  • Julian Khaymovich
  • Saori Wendy Herman
  • Peter David Costantino
Review Article



The aim of this systematic review and meta-analysis was to investigate the relationship between the pre-treatment lymphocyte-to-monocyte ratio (LMR) and prognosis in HNC.


PubMed (via the Web), Embase, Scopus, and the Cochrane Library were searched. A systematic review and meta-analysis was done to generate the pooled hazard ratios (HR) for overall survival (OS) and disease-free survival (DFS).


Our analysis included the results of 4260 patients in seven cohorts. The pooled data demonstrated that an elevated LMR was associated with significantly improved OS (HR 0.5; 95% CI 0.44–0.57), and DFS (HR 0.70; 95% CI 0.62–0.80). Of note, there was no detectable heterogeneity in either OS (I2 = 0%) or DFS (I2 = 0%).


An elevated LMR may be an indicator of favorable prognosis in HNC. However, our results should be interpreted with some degree of caution due to the retrospective nature of cohort studies. Further research with high-quality prospective studies is needed to confirm the effect of LMR in HNC prognosis.


Lymphocyte–monocyte ratio LMR Inflammatory markers Prognosis Head and neck cancer Meta-analysis Systematic review 



No funding was received for this study.

Compliance with ethical standards

Conflict of interest

The authors have no financial or personal disclosures, or conflicts of interest.

Supplementary material

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Supplementary material 1 (DOCX 36 KB)
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Supplementary material 2 (SVG 349 KB)
405_2018_4972_MOESM3_ESM.svg (275 kb)
Supplementary material 3 (SVG 275 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.New York Head and Neck InstituteDonald and Barbara Zucker School of Medicine at Hofstra/NorthwellNew YorkUSA
  2. 2.Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellNew YorkUSA

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