Lymphocyte-to-Monocyte Ratio and Clinical Outcomes in Cholangiocarcinoma: A Systematic Review and Meta-Analysis

Giuseppe Dotto-Vasquez, Andrea K. Villacorta-Ampuero, Juan R. Ulloque-Badaracco, Enrique A. Hernandez-Bustamante, Esteban A. Alarcón-Braga, Percy Herrera-Añazco, Vicente A. Benites-Zapata*, Adrian V. Hernandez

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Lymphocyte-to-Monocyte ratio (LMR) has shown an association with survival outcomes in several oncological diseases. This study aimed to evaluate the association between LMR and clinical outcomes for cholangiocarcinoma patients. A systematic review and meta-analysis were performed to assess the association between LMR values and overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS) and time to recurrence (TTR) in cholangiocarcinoma patients. We used Hazard ratio (HR) and their 95% confidence interval (CI) as a measure of effect for the random effect model meta-analysis. The Newcastle–Ottawa Scale was used for quality assessment. The Egger test and funnel plot were developed for approaching publication bias. A total of 19 studies were included in this study (n = 3860). The meta-analysis showed that cholangiocarcinoma patients with low values of LMR were associated with worse OS (HR: 0.82; 95% CI: 0.71–0.96; I2 = 86%) and worse TTR (HR: 0.71; 95% CI: 0.58–0.86; I2 = 0%). DFS and RFS also were evaluated; however, they did not show statistically significant associations. Low LMR values were associated with a worse OS and TTR.

Original languageEnglish
Article number2655
Issue number11
StatePublished - Nov 2022


  • cholangiocarcinoma
  • lymphocyte–monocyte ratio
  • meta-analysis
  • survival


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