The neutrophil-to-lymphocyte ratio (NLR) in colorectal cancer liver metastasis (CRLM) was evaluated for its predictive usefulness. In order to find papers that looked into the long-term prognostic usefulness of NLR in CRLM, researchers carried out a thorough search through the databases of PubMed, MedLine, and the Cochrane Library. 

Only studies using multivariate analyses were included. A hazard ratio (HR) and 95% CI were used to calculate the effect magnitude. A total of 2,522 patients from 12 studies were included in the meta-analysis, which showed a negative correlation between high NLR and poor overall survival (OS) and disease-free survival (DFS) (HR, 1.95, 95%CI, 1.698-2.223, P< 0.01; HR, 1.80, 95%CI, 1.363-2.363, P <0.01; respectively). 

Those with normal NLR had greater rates of 5-year OS and disease-free survival than patients with high NLR (47% vs. 27%, P< 0.01; 37% vs. 6%, P< 0.01, respectively). No discernible differencewas found  between the individuals with high NLR and those without, according to further study of clinicopathological characteristics. The publishing bias test results from Begg and Egger (P = 0.891 and P = 0.926, respectively) did not show any discernible bias. Through the use of multivariate analysis, it was shown that NLR had strong prognostic capabilities in CRLM, which may be utilized to guide treatment choices and forecast clinical outcomes. 

To validate the conclusion, more multicenter randomized controlled studies are necessary.