The elevated preoperative derived neutrophil-to-lymphocyte ratio predicts poor clinical outcome in breast cancer patients

Abstract

Existing preclinical and clinical data suggest that the presence of a systemic inflammatory response plays a critical role in the progression of several solid tumors. The derived neutrophil-to-lymphocyte ratio (dNLR) represents an easily determinable marker of systemic inflammation and has been proposed as a potential prognostic marker. The present study was performed to validate and further clarify the prognostic relevance of an elevated pre-treatment dNLR in a large cohort of European breast cancer patients. Data from 762 consecutive female breast cancer patients treated from 1999 to 2004 were evaluated. Disease-free survival (DFS) and overall survival (OS) were assessed using the Kaplan-Meier method. To evaluate the prognostic relevance, univariate and multivariate Cox regression models were performed for each endpoint. Applying receiver operating characteristics (ROC) analysis, the optimal cutoff level for the dNLR was 3. In univariate analysis, a dNLR ≥3 was associated with poor DFS (hazard ratio (HR) 1.87, 95 % confidence interval (CI) 1.28-2.73, p = 0.001) and OS (HR 1.67, 95 % CI 1.07-2.63, p = 0.025). Multivariate analysis revealed a significant association between the elevated dNLR and poor DFS (hazard ratio (HR) 1.70, 95 % CI 1.09-2.65, p = 0.018) but did not show a significant association between the dNLR and OS (HR 1.54, 95 % CI 0.91-2.59, p = 0.106). The present study shows that the pre-treatment dNLR is an independent prognostic factor that could be useful for future individual risk assessment in breast cancer patients.

Elevated NLR in gallbladder cancer and cholangiocarcinoma – making bad cancers even worse: results from the US Extrahepatic Biliary Malignancy Consortium

“…This finding is consistent with other smaller studies demonstrating that elevated NLR portends poor prognosis in solid tumor malignancies. [1][2][3][4][5][6][7][8][9][10][11][12][13] Other studies in patients with hepato-pancreato-biliary (HPB) cancers agree with the findings presented in this paper. In a study of 452 patients who underwent a HPB procedure for malignant disease, NLR >5 was found to be associated with worse OS.…”

Metastatic axillary node ratio predicts recurrence and poor long-term prognosis in patients with advanced stage IIIC (pN3) breast cancer

“…Our study also found that mALNR was most significantly related to prognosis including recurrence and mortality. The metastatic lymph node ratio in other various cancer types is also thought to be an independent prognostic factor [212223]. Similar to previous studies, we found that a higher mALNR was associated with poor long-term prognosis in breast cancer.…”

Comparison of the prognostic values of selected inflammation based scores in patients with medullary thyroid carcinoma: A pilot study

“…A low PNI has been found to be associated with a poor prognosis in various malignancies . Moreover, other inflammation based scores such as derived neutrophil‐to‐lymphocyte ratio (dNLR) and lymphocyte‐to‐monocyte ratio (LMR) were also confirmed to be valuable in predicting tumor outcomes …”

“…23,24 Moreover, other inflammation based scores such as derived neutrophil-to-lymphocyte ratio (dNLR) and lymphocyte-to-monocyte ratio (LMR) were also confirmed to be valuable in predicting tumor outcomes. 25,26 However, to our knowledge, dNLR, LMR, PNI, and plasma fibrinogen have never been investigated in patients with MTC. Furthermore, which inflammation based scores are more suitable for predicting clinical outcomes, including lymph node metastasis, capsule invasion, advanced tumor stages, and recurrence, remain unclear in MTC.…”