Neutrophil to Lymphocyte Ratio after Treatment Completion as a Potential Predictor of Survival in Patients with Triple-Negative Breast Cancer

Kwangmin Kim; Hyang Suk Choi; Hany Noh; In-Jeong Cho; Seung Taek Lim; Jong-In Lee; Ai Ri Han

doi:10.4048/jbc.2021.24.e43

Neutrophil to Lymphocyte Ratio after Treatment Completion as a Potential Predictor of Survival in Patients with Triple-Negative Breast Cancer

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Type: Academic journal

Author: Kwangmin Kim (Department of Surgery Yonsei University Wonju College of Medicine Wonju Korea) Hyang Suk Choi (Department of Surgery Yonsei University Wonju College of Medicine Wonju Korea) Hany Noh (Department of Surgery Yonsei University Wonju College of Medicine Wonju Korea) In-Jeong Cho (Department of Surgery Yonsei University Wonju College of Medicine Wonju Korea)

Journal: 한국유방암학회 Journal of Breast Cancer Journal of Breast Cancer Vol.24 No.5 KCI Accredited Journals

Published: 2021.10

Pages: 443 - 454 (12page)

DOI: 10.4048/jbc.2021.24.e43

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Neutrophil to Lymphocyte Ratio after Treatment Completion as a Potential Predictor of Survival in Patients with Triple-Negative Breast Cancer

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Purpose Triple-negative breast cancer (TNBC) has been associated with worse prognosis, and biomarkers are needed to identify high-risk patients who may benefit from clinical trials or escalated treatment after completion of standard treatment. We aimed to assess whether the post-treatment neutrophil-to-lymphocyte ratio (NLR) can reflect patient prognosis and determine the follow-up period that can provide the most feasible data. Methods In this retrospective analysis involving patients with TNBC, clinicopathological data, including those on peripheral complete blood cell count, were collected. The prognostic powers of serial NLRs obtained at baseline and after treatment completion were compared. Kaplan-Meier curves were generated to compare the overall survival (OS) and distant disease-free survival (DDFS). Results In total, 210 patients were enrolled. Forty-three (20.5%) events were detected. Two-thirds of the events (29/43) were related to breast cancer. Most recurrent breast cancer-related diseases (27/29) were detected within 5 years of the initial diagnosis. In contrast, half of the events due to secondary malignancies or non-breast-related diseases (7/14) occurred 5 years after the initial diagnosis. Comparison of the prognostic performance of NLRs at baseline and at 6, 12, and 24 months after treatment completion revealed the strongest prognostic performance at 6 months after treatment completion (area under the curve = 0.745). The high NLR group (NLR >2.47) showed worse OS (p = 0.006) and DDFS (p < 0.001) than low NLR group. Conclusion Elevated post-treatment NLR was significantly associated with worse survival in patients with TNBC. We believe that it can be a useful surrogate marker for identifying high-risk patients with TNBC.

#Lymphocytes #Neutrophils #Survival #Triple negative breast neoplasms

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