Pretreatment neutrophil-to-lymphocyte ratio predicts lymph node metastasis in triple-negative breast cancer
Arun Philip1, Mathews Jose1, Wesley M Jose1, DK Vijaykumar2, Keechilat Pavithran1
1 Department of Medical Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidhyapeetham, P.O.AIMS Ponekkara, Kochi, Kerala, India
2 Department of Gynecologic Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidhyapeetham, P.O.AIMS Ponekkara, Kochi, Kerala, India
Background: The purpose of the study was to investigate the value of pretreatment neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker in triple-negative breast cancer (TNBC) and to see its bearing on the clinical and pathological stage of the disease.
Methods: This was a retrospective analysis of cases of TNBC treated at our center from 2006 to 2013. The pretreatment complete blood count was recorded from which the NLR was calculated as the percentage of neutrophils divided by the percentage of lymphocytes. The association between pretreatment NLR with the stage of the disease, clinical and pathological lymph node status, and disease-specific survival was analyzed.
Results: A total of 208 patients were eligible for the analysis. The median follow-up period was 48 months. The NLR was found to have a strong correlation with the pathological nodal status and the clinical stage (75% cases node-positive in the high NLR group versus 36% in the low NLR group; P < 0.01). At the time of analysis, 74% of our study population was alive and well. There was no significant correlation between the NLR and the overall survival.
Conclusions: Based on our study, we conclude that the pretreatment NLR is strongly associated with lymph node metastasis and clinical stage in TNBC patients. It is probably not useful as a prognostic marker, as it does not seem to have any significant bearing on the overall survival.
Department of Medical Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidhyapeetham, P.O.AIMS Ponekkara, Kochi, Kerala
Source of Support: None, Conflict of Interest: None