{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:54:48Z","timestamp":1790283288554,"version":"4.1.0"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Lung Immune Prognostic Index (LIPI), derived from the derived neutrophil-to-lymphocyte ratio and lactate dehydrogenase, integrates systemic inflammation and tumour burden. Its prognostic utility in urological malignancies has not been comprehensively quantified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review and meta-analysis in accordance with PRISMA and a prospectively registered protocol. PubMed, Embase, and the Cochrane Library were searched through October 2025. Eligible cohort studies or trials evaluated associations between LIPI categories (good\/intermediate\/poor) and survival outcomes in renal cell carcinoma, urothelial carcinoma, and prostate cancer. Random-effects models were fitted using REML with Hartung-Knapp adjustment. When hazard ratios (HRs) were not directly reported, we reconstructed pseudo-individual patient data from Kaplan-Meier curves to estimate HRs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen studies (19 independent cohorts; 5,304 patients) were included. Compared with good LIPI, intermediate LIPI was associated with worse overall survival (OS) (HR 1.73, 95% CI 1.52-1.98) and shorter progression-free survival (PFS; including disease-free survival after surgery where applicable) (HR 1.39, 95% CI 1.13-1.71). Poor LIPI showed a stronger association with inferior OS (HR 3.73, 95% CI 2.95-4.71) and PFS (HR 2.69, 95% CI 1.96-3.70). Prognostic gradients were generally consistent across tumour types and treatment settings, including immune checkpoint inhibitor-treated cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LIPI is a readily available biomarker that provides robust risk stratification across major urological cancers and may support treatment planning and trial stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251235082<\/jats:ext-link>\n                      , identifier CRD420251235082.\n                    <\/jats:p>\n                  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