Predictive Value of Neutrophil/Lymphocyte Ratio for Efficacy of Preoperative Chemotherapy in Triple-Negative Breast Cancer.
BACKGROUND
The neutrophil/lymphocyte ratio (NLR) has been reportedly associated with prognosis in cancer patients by influencing both cancer progression and chemosensitivity. However, the correlation between NLR and the outcome of neoadjuvant chemotherapy (NAC) in breast cancer patients remains unclear.


METHODS
NLR was evaluated in 177 patients with breast cancer treated with NAC with 5-fluorouracil, epirubicin, and cyclophosphamide, followed by weekly paclitaxel and subsequent curative surgery. The correlation between NLR and prognosis, including the efficacy of NAC, was evaluated retrospectively.


RESULTS
NLR ranged from 0.5 to 10.6. Fifty-eight patients with low NLR (<3.0) had a higher pathological complete response (pCR) rate (p < 0.001) and were more frequently diagnosed with ER-negative/progesterone receptor (PR)-negative/HER2-negative (triple-negative) breast cancer (TNBC; p < 0.001) compared with patients with high NLR (≥3.0). Among TNBC patients who achieved pCR, disease-free survival (p = 0.006) and overall survival (p < 0.001) were significantly longer in patients with low NLR than in those with high NLR. Low NLR was associated with a significantly favorable prognosis in TNBC patients who achieved pCR, according to univariate analysis (p = 0.044, hazard ratio = 0.06).


CONCLUSIONS
Low NLR may indicate high efficacy and favorable outcome after NAC in patients with TNBC.
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Yuka
Y
Asano
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan. spqv9ke9@view.ocn.ne.jp.
Shinichiro
S
Kashiwagi
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Naoyoshi
N
Onoda
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Satoru
S
Noda
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Hidemi
H
Kawajiri
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Tsutomu
T
Takashima
Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Masahiko
M
Ohsawa
Department of Physiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Seiichi
S
Kitagawa
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan.
Kosei
K
Hirakawa
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008214:Lymphocytes / Q000187:drug effects / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D009504:Neutrophils / Q000187:drug effects / Q000378:metabolism / Q000473:pathology*; D017239:Paclitaxel / Q000008:administration & dosage; D011300:Preoperative Care; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*
D014408:Biomarkers, Tumor; D003520:Cyclophosphamide; D015251:Epirubicin; D005472:Fluorouracil; D017239:Paclitaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone