title: Predicting the role of the pretreatment neutrophil to lymphocyte ratio in the survival of early triple-negative breast cancer patients.
abstract: OBJECTIVE
  Increasing evidence supports an association between systemic inflammation and cancer development and progression. The neutrophil to lymphocyte ratio (NLR) is used as a basic parameter of systemic inflammation in some tumors. The aim of this study was to examine the association between the pretreatment NLR, disease-free survival (DFS), and overall survival (OS) in patients with early triple-negative breast cancer (TNBC).
  
  
  METHODS
  We retrospectively studied patients diagnosed with stage I-III TNBC who had completed all phases of primary treatment from 2002 to 2013. The association between the pretreatment NLR and survival was analyzed. The difference among variables was calculated by chi-square test. OS and DFS were assessed using the Kaplan-Meier method. Multivariate Cox proportional hazards models were used to analyze the prognostic impact of clinical parameters.
  
  
  RESULTS
  Eighty-five patients were eligible for study inclusion. There were no statistically significant differences among the pretreatment NLR and clinicopathological variables. Patients with an NLR of > 2 had significantly lower DFS (p=0.002) and OS (p=0.03) than patients with an NLR of ≤ 2. Multivariate Cox proportional hazards models showed that a higher pretreatment NLR was independently correlated with poor DFS and OS, with a hazard ratio 5.46 (95% confidence interval [CI] 1.61-18.85, p=0.006) and 2.86 (95% CI 1.04-7.86, p=0.04), respectively.
  
  
  CONCLUSIONS
  Patients with early TNBC and with elevated pretreatment NLR showed poorer DFS and OS than patients without elevated NLR. However, this finding needs to be confirmed in a large prospective study.
authors: Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey.
authors: Oktay
authors: O
authors: Bozkurt
authors: Halit
authors: H
authors: Karaca
authors: Veli
authors: V
authors: Berk
authors: Mevlude
authors: M
authors: Inanc
authors: Ayse
authors: A
authors: Ocak Duran
authors: Ersin
authors: E
authors: Ozaslan
authors: Mahmut
authors: M
authors: Ucar
authors: Metin
authors: M
authors: Ozkan
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008214:Lymphocytes; D008875:Middle Aged; D009504:Neutrophils; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D064726:Triple Negative Breast Neoplasms / Q000097:blood / Q000401:mortality*