Pretreatment systemic immune-inflammation index and lymphocyte-to-monocyte ratio as prognostic factors in oral cavity cancer - A meta-analysis

Q: How were SII and LMR evaluated in oral cavity cancer patients?

The study conducted a comprehensive meta-analysis using PubMed, Embase, and the Cochrane Library to collect hazard ratios and 95% confidence intervals linking SII/LMR with overall survival and disease-free survival.

Q: What is the relationship between SII and survival outcomes?

In pooled analysis, increased SII predicted poorer overall survival and disease-free survival in oral cavity cancer patients.

Q: How does LMR relate to prognosis in oral cavity cancer?

High LMR was associated with improved overall survival and disease-free survival, indicating a favorable prognostic marker.

Sep 21, 2026

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This meta-analysis evaluates whether pretreatment systemic immune-inflammation index (SII) and lymphocyte-to-monocyte ratio (LMR) predict outcomes in oral cavity cancer, addressing inconsistent prior evidence. Searches of PubMed, Embase, and the Cochrane Library identified 18 studies with 19 trials. Pooled results show higher SII associates with worse overall survival and disease-free survival, whereas higher LMR links to improved survival. Subgroup analyses indicate high SII and low LMR correlate with poorer overall survival across study characteristics.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

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Abstract

Introduction

Materials and Methods

Results

Discussion

Conclusions

® Systematic Review and Meta-Analysis Pretreatment systemic immune-inflammation index and lymphocyte-to-monocyte ratio as prognostic factors in oral cavity cancer A meta-analysis Jianghan Xu, MMa , Yanjun Lin, PhDa , Jingbo Yang, MMb , Yifeng Xing, MMa , Xiaojie Xing, PhDa ,* | Abstract
Background: The predictive implications of the pretreatment systemic immune-inflammation index (SII) and lymphocyte-tomonocyte ratio (LMR) in oral cavity cancer have been investigated extensively, however, the findings are conflicting.
Methods: To assess the predictive importance of SII and LMR in patients with oral cavity cancer, a comprehensive Metaanalysis of the literature was conducted using the databases from PubMed, Embase, and the Cochrane Library. To determine the link between SII and LMR and overall survival (OS) and disease-free survival (DFS), hazard ratio (HR) and 95% confidence interval (CI) were retrieved.
Results: The analysis comprised a total of 18 papers, covering 19 trials (SII = 5, LMR = 12, SII + prognostic nutritional index (PNI) = 2) . According to pooled data, increased SII predicted poor OS (HR: 1.61, 95% CI: 1.38–1.87, P < .001) and DFS (HR: 1.90, 95% CI: 1.11–3.27, P = .02) while high LMR was linked with improved OS (HR: 0.64, 95% CI: 0.54–0.77, P < .001) and DFS (HR: 0.69, 95% CI: 0.61–0.79, P < .001) . In addition, subgroup analysis indicated that high SII and low LMR negatively correlated with OS regardless of country, cutoff value, sample size, or types of Cox regression analysis.
Conclusions: High SII and low LMR may predict worse survival in patients with oral cavity cancer. SII and LMR may therefore represent effective indicators of prognosis in oral cavity cancer.
Abbreviations: DFS = disease-free survival, HR = hazard ratio, LMR = lymphocyte-to-monocyte ratio, NOS = NewcastleOttawa Quality Assessment Scale, OS = overall survival, PNI = prognostic nutritional index, SII = systemic immune-inflammation index, TNM = tumor-node-metastasis. | | --- | | Keywords: lymphocyte-to-monocyte 2 3 ratio, meta-analysis, oral cavity cancer, prognosis, systemic immune-inflammation index | 1. Introduction The most frequent kind of cancer in the head and neck region, oral cavity cancer, is one of the main causes of cancer fatalities and a serious public health concern globally.[1,2] Oral cavity cancer is expected to be the eighteenth most often diagnosed cancer and the sixteenth main cause of cancer-related mortality globally, with more than 370,000 new cases and 170,000 deaths per year, according to global cancer data. [3] Despite advances in illness detection, staging, and therapy, 5-year overall survival (OS) has not grown appreciably during the last 2 decades. [4] Surgery, radiation, and chemotherapy have been the primary methods for managing oral cavity cancer, either individually or in combination, thus far. Additionally, each patient requires personalized treatment strategies based on factors like cancer type, stage, presence of metastasis or lymph node involvement, and overall health. Typically, early-stage cancers are treated with a single method such as surgery or radiotherapy, while advanced cases often require a combination of treatments like surgery with chemoradiotherapy or chemotherapy with immunotherapy to improve prognosis. Designing a tailored treatment plan based on patients’ predicted survival time can be advantageous in improving the cure rate of oral cavity cancer and enhancing the quality of patient survival. Currently, the JX, YL, and JY contributed equally to this work. This work was financially supported by the Natural Science Foundation of Fujian Province (no. 2021J01792). The authors have no conflicts of interest to disclose. The data that support the findings of this study are available from a third party, but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are ava

FAQs

How were SII and LMR evaluated in oral cavity cancer patients?

The study conducted a comprehensive meta-analysis using PubMed, Embase, and the Cochrane Library to collect hazard ratios and 95% confidence intervals linking SII/LMR with overall survival and disease-free survival.

What is the relationship between SII and survival outcomes?

In pooled analysis, increased SII predicted poorer overall survival and disease-free survival in oral cavity cancer patients.

How does LMR relate to prognosis in oral cavity cancer?

High LMR was associated with improved overall survival and disease-free survival, indicating a favorable prognostic marker.

Sep 21, 2026

Upload by Eden