Elevated neutrophil to lymphocyte ratio to predict survival outcome after recurrence for patients with triple-negative breast cancer.

24 Background: Recent studies show that obesity plays a major role in causing chronic inflammation by producing several inflammatory cytokines. On the other hand, there is limited research focusing on the effect of obesity in recurrent breast cancer treatments. Therefore, we set out to clarify the impact of obesity related inflammation by Neutrophil to Lymphocyte ratio (N/L ratio) in recurrent breast cancer treatment. Methods: From January 2005 to December 2014, 93 patients with recurrent breast cancer after surgery were included. World Health Organization body mass index (BMI) classification was used for evaluating the degree of obesity. Muscle mass amount was also analyzed. Lumber skeletal muscle index (LSMI, cm2/m2) was generated by standardizing each patient’s muscle area (m2) at the third lumber vertebrae level in axial CT data. Less than 50m2 in LSMI was defined as pre-sarcopenia. N/L ratio was calculated from the laboratory data, and more than 3.0 was defined as high N/L group. Results: Patient background showed there were 20 overweight patients and 2 obese patients. Twenty-eight cases had pre-sarcopenia. In univariate analysis, N/L ratio had no significant differences among BMI categories. However, triple negative (TN) type demonstrated significantly high N/L ratio compared to other subtypes (p < 0.05). LMSI had significant negative correlation to N/L ratio (p < 0.05). In survival analysis, Overweight/Obese group showed significantly shorter OS (p < 0.05). High N/L ratio group also showed similar results (p < 0.05). When stratified by intrinsic subtypes, TN type demonstrated significantly shorter OS (p < 0.05). Additionally, Overweight/Obese groups in TN type had notably shorter OS (p < 0.05). In multivariate analysis, subtype and N/L ratio were independently related to OS (Hazard ratio: 3.3 in TN type, 2.9 in High NL ratio group). Conclusions: Present study did not show any significant relationship between obesity and chronic inflammation in recurrent breast cancer setting. On the contrary, intrinsic subtype was significantly related to inflammation, leading to pre-sarcopenia and worse OS. Whether obesity promotes inflammation in TN type needs more investigation.

Download Full-text

Neutrophil-to-lymphocyte ratio as a prognostic factor for patients with metastatic or recurrent breast cancer treated using capecitabine: a retrospective study

BMC Cancer ◽

10.1186/s12885-021-09112-9 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Shigemasa Takamizawa ◽

Tatsunori Shimoi ◽

Natsuko Satomi-Tsushita ◽

Shu Yazaki ◽

Toshihiro Okuya ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factor ◽

Progression Free Survival ◽

Recurrent Breast Cancer ◽

Neutrophil To Lymphocyte Ratio ◽

Cancer Center ◽

Lymphocyte Ratio ◽

Lymphocyte To Monocyte Ratio ◽

Third Line ◽

Recurrent Breast

Abstract Background Eribulin or capecitabine monotherapy is the next cytotoxic chemotherapy option for patients with metastatic or recurrent breast cancer who have previously received an anthracycline or a taxane. However, it is unclear what factors can guide the selection of eribulin or capecitabine in this setting, and prognostic factors are needed to guide appropriate treatment selection. The neutrophil-to-lymphocyte ratio (NLR) is a prognostic factor for eribulin-treated patients, although it is unclear whether it is a prognostic factor for capecitabine-treated patients. Therefore, we analysed the ability of the NLR to predict oncological outcomes among patients who received capecitabine after previous anthracycline or taxane treatment for breast cancer. Methods We retrospectively reviewed the medical records of patients with metastatic or recurrent breast cancer who had previously received anthracycline or taxane treatment at the National Cancer Center Hospital between 2007 and 2015. Patients were included if they received eribulin or capecitabine monotherapy as first-line, second-line, or third-line chemotherapy. Analyses of overall survival (OS) and progression-free survival (PFS) were performed according to various factors. Results Between 2007 and 2015, we identified 125 eligible patients, including 46 patients who received only eribulin, 34 patients who received only capecitabine, and 45 patients who received eribulin and capecitabine. The median follow-up period was 19.1 months. Among eribulin-treated patients, an NLR of <3 independently predicted better OS. Among capecitabine-treated patients, an NLR of <3 independently predicted better PFS but not better OS. In addition, a lymphocyte-to-monocyte ratio of ≥5 was associated with better PFS and OS. Conclusions To the best of our knowledge, this is the first study to evaluate whether the NLR is a prognostic factor for capecitabine-treated patients with metastatic or recurrent breast cancer. However, the NLR only independently predicted PFS in this setting, despite it being a useful prognostic factor for other chemotherapies.

Download Full-text

Systemic Immune-Inflammation Index Is Superior to Neutrophil to Lymphocyte Ratio in Prognostic Assessment of Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy

BioMed Research International ◽

10.1155/2020/7961568 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Cong Jiang ◽

Yubo Lu ◽

Shiyuan Zhang ◽

Yuanxi Huang

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Cancer Patients ◽

Regression Models ◽

Roc Analysis ◽

Neutrophil To Lymphocyte Ratio ◽

Breast Cancer Patients ◽

Lymphocyte Ratio ◽

Immune Inflammation ◽

The Impact

Background and Methods. As a parameter integrating neutrophil (N), lymphocyte (L), and platelet (P) levels, altered systemic immune-inflammation index (SII) has been investigated in a number of malignant tumor types. Here, we explore the impact of SII in a cohort of 249 breast cancer patients receiving neoadjuvant chemotherapy (NAC), investigating the prognostic value of SII, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). All patients had complete follow-up data and pathological confirmation of breast cancer by a core needle biopsy prior to NAC treatment and surgery. All blood samples were obtained within one week prior to NAC. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off value for patient classification by SII, NLR, and PLR. Associations between clinicopathological variables by SII, NLR, and PLR were determined by a chi-squared test or Fisher’s exact test. Overall survival (OS) analysis was performed using Kaplan-Meier plots, log-rank tests, and Cox proportional hazards regression models. The Z test is used to compare the prognostic ability of SII, NLR, and PLR. Results. SII, NLR, and PLR did not define patient groups with distinct clinicopathological characteristics. SII, NLR, and PLR cut-off values were 547, 2.13, and 88.23, as determined by ROC analysis; the corresponding areas under the curve (AUCs) were 0.625, 0.555, and 0.571, respectively. Cox regression models identified SII as independently associated with OS. Patients with low SII had prolonged OS (65 vs. 41 months, P = 0.017 , HR: 3.24, 95% CI: 1.23-8.55). In the Z test, the difference in AUC between SII and NLR was statistically significant ( Z = 2.721 , 95% CI: 0.0194-0.119, P = 0.0065 ). Conclusion. Our study suggests that the pretreatment SII value is significantly correlated with OS in breast cancer patients undergoing NAC and that the prognostic utility of SII is superior to that of NLR and PLR.

Download Full-text