An increased neutrophil-to-lymphocyte ratio predicts poorer survival following recurrence for patients with breast cancer

Abstract

The aim of the present study was to evaluate the association between changes in the neutrophil-to-lymphocyte ratio and the survival rate, as well as tumor subtype, in recurrent breast cancer. Patients with recurrent breast cancer following surgery were included in this study. NLR was calculated and compared between two time points: Pre-treatment and recurrence. The associations between the longitudinal NLR change, the NLR at the time of recurrence and overall survival following recurrence (OSrec) were evaluated. A total of 89 patients were evaluated. NLR increased by 0.59 at recurrence, as compared with the initial treatment (P<0.05). The triple negative (TN) type demonstrated 4.59 in NLR, which was the highest among the four subtypes at the time of recurrence (P<0.05). The highest change (an increase of 2.0) was observed in TN type cancer (P<0.05). Patients with high NLR upon recurrence demonstrated significantly shorter OSrec rates (P<0.05). On the other hand, patients with an NLR increased by more than a third quartile demonstrated a shorter OSrec rate (P=0.06). When adjusted by covariates, the NLR and tumor subtype were determined to be associated with OSrec (P<0.05). Therefore, an increased NLR predicts survival, even in patients with recurrent breast cancer, and the NLR is potentially useful as an inflammation marker for TN breast cancer.

Neutrophils, G‐CSF and their contribution to breast cancer metastasis

“…Interestingly, we found only one study comparing NLR measurements between two different time points: pretreatment and at recurrence. The study by Iwase et al [23] found an increase in NLR by an average of 0.59 at recurrence compared to the initial measurement in a small study on patients with recurrent breast cancer. It was also reported that TNBC patients in this study demonstrated the highest NLR at recurrence (4.59) as well as the greatest increase in NLR (increase of 2.0) at recurrence.…”

The Neutrophil to Lymphocyte Ratio Predicts the Response to Neoadjuvant Chemotherapy in Luminal B Breast Cancer

“…A study in patients with post-surgery recurrent disease found a 0.59 increase in NLR (relative to its value at diagnosis) associated to recurrence (Iwase et al, 2017). On the other hand, a study that assessed NLR and the Lymphocyte to Monocyte Ratio (LMR) in 1570 patients concluded that NLR > 2 and LMR > 4.8 were associated to better DFS.…”

Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer

“…Increasing evidence suggests that high preoperative PNI is a predictor of better postoperative complications and patients outcomes in various types of malignancy [4][5][6][7][8][9][10]. Meanwhile, both high serum albumin level and low preoperative NLR also have been reported to be associated with better postoperative outcomes in several cancers [19][20][21][22][23][24][25][26][27]. BMI is also a well-known prognostic factor in breast cancers [28][29][30], and body weight is also associated with the patients' nutritional condition [31].…”