The Usefulness of the Pretreatment Neutrophil/Lymphocyte Ratio as a Predictor of the 5-Year Survival in Stage 1–3 Triple Negative Breast Cancer Patients |
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| Authors: | Basem Azab Julia R Amundson Alessia Cioci Heather Stuart Danny Yakoub Eli Avisar Fredrick Moffat Alan S Livingstone Dido Franceschi |
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| Institution: | aSurgical Oncology, Sentara Healthcare, Hampton, Virginia, USA;bDepartment of Surgery, University of Chicago, Chicago, Illinois, USA;cDepartment of Surgical Oncology, University of Miami, Miami, Florida, USA;dDepartment of Surgical Oncology, University of British Colombia, Vancouver, British Columbia, Canada;eDepartment of Surgical Oncology, University of Tennessee, Memphis, Tennessee, USA |
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| Abstract: | BackgroundWe have previously shown that the neutrophil/lymphocyte ratio (NLR) is a predictor of survival among breast cancer patients. The aim of this study was to determine the predictive value of NLR among different nodal and chemotherapy subgroups of triple negative breast cancer (TNBC).MethodsPatients with stage 1–3 TNBC who underwent treatment from 2007 to 2014 and had blood counts prior to treatments were included. Patients were categorized into high (≥2) and low (<2) NLR groups. Primary outcomes were overall survival (OS) and disease-free survival (DFS).ResultsThe average follow-up time was 54 months. The high NLR group had worse OS (HR 2.8, CI 1.3–5.9, p < 0.001) and DFS (HR 2.3, CI 1.2–4.2, p < 0.001) than the low NLR group. After adjusting for confounding variables, high NLR was an independent prognostic factor for both OS (HR 5.5, CI 2.2–13.7, p < 0.0001) and DFS (HR 5.2, CI 2.3–11.6, p < 0.0001). Categorization of TNBC patients by NLR (high vs. low) and nodal status (positive vs. negative) resulted in four groups with significantly different OS and DFS (log rank p < 0.0001). Significant improvements in OS (p < 0.001) and DFS (p < 0.001) were observed for patients who received chemotherapy and had high NLR but not for patients with low NLR (p = 0.65 and p = 0.07, respectively).ConclusionHigh pretreatment NLR is an independent predictor of poor OS and DFS among TNBC patients. Combining NLR and pN provides better risk stratification for TNBC patients. Chemotherapy appears to be beneficial only in patients with high NLR. Larger prospective studies are needed to validate these findings. |
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| Keywords: | Neutrophil/lymphocyte ratio Triple negative breast cancer Mortality |
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