Pre-treatment neutrophil-lymphocyte and platelet-lymphocyte ratios as additional markers for breast cancer progression: A retrospective cohort study

Abstract

Background Breast cancer is the most prevalent cancer that causes significant morbidity and loss of productivity. Around a third of all breast cancer patients are potentially develop distant metastases albeit the current implementation of multidisciplinary treatment. A simple but effective marker to predict the risks of cancer progression is very important for clinicians to improve treatment and surveillance. Methods We recruited 1083 non-metastatic patients and analyzed the ratios of neutrophil to lymphocyte (NLR) and platelet to lymphocyte (PLR) in relation to progression-free survivals (PFS) and risks of distant metastases. Results Baseline clinicopathological variables were not significantly different in the pretreatment NLR and PLRs. Using maximum points of sensitivity and specificity of the Receiver Operating Characteristic (ROC) curve, cut-off values were determined 2.8 for NLR and 170 for PLR. Higher NLR was associated with skin and chest wall cancer infiltration (T4, P = 0.0001). Elevated PLR was associated with more advanced stages at diagnosis ( P = 0.03). High NLR values were significantly associated with risks of disease progression (OR 1.555, 95% CI: 1.206–2.005, P = 0.001). Patients with high NLR had shorter PFS (34.9 vs 53.5 months, Log-rank test = 0.001) and shorter time to develop recurrent distant metastatic disease (66.6 vs 104.6 months, Log-rank test = 0.027). Conclusion High NLR is significantly associated with higher risk of disease progression and shorter time to develop metastases particularly among breast cancer patients diagnosed in the advanced stages.

Platelet-to-lymphocyte ratio associated with the clinicopathological features and prognostic value of breast cancer: A meta-analysis

“…After reading the full text, 18 articles without relevant indicators of survival outcome were excluded; finally, 20 articles were included. 19–38 The characteristics of the included studies are summarized in Table 1. The 20 studies 19–38 were published between 2014 and 2021 with the sample size ranging from 62 to 1083; 12 studies were carried out in Asian countries and 8 studies in other regions.…”

“…19–38 The characteristics of the included studies are summarized in Table 1. The 20 studies 19–38 were published between 2014 and 2021 with the sample size ranging from 62 to 1083; 12 studies were carried out in Asian countries and 8 studies in other regions. Pathological types included HER2 positive and negative.…”

“…Multivariate analysis was adopted in 19 studies. 19–38 The follow-up months ranged from 60 to 200 months in these studies, with NOS scores of 6–8 points (Table S1).…”

“…To analyze the association between PLR and clinicopathological characteristics in breast cancer patients, we pooled the results in studies with stratification of age, 19,20,25,27,29–32,35–37 LNM, 19–37 TNM stage, 19,20,22,24,25,27,29–32,34–37 tumor size, 19,20,24,29,31,32,35,37 and distant metastasis 19,20,24,29,31,32,35,37 (Table S3). The obtained results indicated no significant association of PLR with age (OR = 0.87; 95% CI 0.66, 1.16; P = 0.34) (Figure 4(a)), and tumor size (OR = 1.41; 95% CI 0.98, 2.02; P = 0.06) (Figure 4(c)).…”

The prioritation and gap of preoperative COVID-19 vaccination in cancer surgery of the breast, head and neck, and skin: A cohort study of 367 patients in an Indonesian hospital

“…Surgery itself is also associated with higher risk of virus exposure due to proinflammatory cytokines and mechanical ventilation [ 22 ]. In patients with advanced cancer stages at diagnosis as commonly found in developing countries, systemic proinflammatory markers are usually also higher [ 24 ] that might increase risks of complication after surgery. Preexisting comorbidities have been associated with higher hesitancy to receive COVID-19 vaccination due to safety concerns [ 11 , 14 ].…”