Prognostic Value of the Neutrophil-Lymphocyte Ratio in Triple Negative Breast Cancer Patients

Abstract

Objective: To assess the prognostic value of the neutrophil-lymphocyte ratio (NLR) in a cohort of triple-negative breast cancer patients (TNBC) treated in a regional cancer center.

Methods: The electronic medical records of 214 consecutive patients treated with surgery, chemotherapy, and radiotherapy between 2006 and 2016 were reviewed. The prognostic significance of the NLR for disease-free survival (DFS) and overall survival (OS) was examined in relation to clinical and treatment-related factors. Overall survival and DFS were assessed using the Kaplan-Meier method; Cox semi-parametric regression modelling was used for multivariate analysis.

Results: Ninety patients were eligible; median follow-up was 45.6 months (range, 6-105 months). The 3-year OS rate was 77.9% and the 5-year OS rate 61.7%. Patients with an NLR of ≤1.7 had significantly better DFS (P=0.029) than patients with an NLR>1.7; OS approached statistical significance (P=0.055). When treatment-related factors - significant on univariate analysis - were entered into the multivariate model, only nodal status N2/N3 remained as significant for DFS (P=0.0078) and advanced T-stage (T3, T4) significant for OS (P=0.014).

Conclusion: While NLR is associated with survival in TNBC patients on univariate analysis, the prognostic value of NLR is likely due to its association with other clinicopathological factors.