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Background The monocyte-to-lymphocyte ratio(MLR) as an immune indicator has been found to be associated with the prognosis of various tumors. This study aimed to determine prognostic value of MLR in patients with hepatocellular carcinoma (HCC) by the meta-analysis. Methods A comprehensive literature search was conducted in PubMed, Web of Science, and Embase up to July 25, 2025. Survival outcome included overall survival (OS), recurrence free survival (RFS), progression-free survival (PFS), and disease-free survival (DFS) were analyzed. Results A total of 17 studies comprising 7113 patients were included in the meta-analysis. The pooled results displayed that high MLR was significantly associated with poor OS (HR:1.57,95% CI:1.22-2.02), RFS(HR:2.40,95%CI:1.73-3.33) and PFS(HR:2.04,95%CI:1.57-2.65).However, high MLR was not associated with DFS(HR:1.01,95%CI:0.86-1.18). The prognostic relevance of MLR in HCC was consistently demonstrated across subgroup analyses. Conclusion High MLR was associated with poor prognosis in patients with HCC. MLR may be a valuable and non-invasive prognostic indicator for HCC patients in clinical practice.
Zhou et al. (Fri,) studied this question.