title: Platelet-Lymphocyte Ratio as a Useful Predictor of the Therapeutic Effect of Neoadjuvant Chemotherapy in Breast Cancer.
abstract: BACKGROUND
  The peripheral blood platelet-lymphocyte ratio (PLR) has been proposed as an indicator for evaluating systemic inflammatory responses in cancer-bearing patients. While some reports suggest a correlation between PLR and prognosis, few studies have examined the relationship between PLR and sensitivity to chemotherapy. We conducted a study on whether PLR could serve as a predictor of the therapeutic effects of neoadjuvant chemotherapy (NAC).
  
  
  METHODS
  PLR was evaluated in 177 breast cancer patients treated with the NAC 5-fluorouracil, epirubicin and cyclophosphamide, followed by weekly paclitaxel and subsequent curative surgery. The correlation between PLR and prognosis, and between PLR and the efficacy of NAC, were evaluated retrospectively.
  
  
  RESULTS
  The low PLR group had significantly more patients > 56 years old (p = 0.001) and postmenopausal women (p = 0.001) than the high PLR group. The low PLR group also had a higher pathologic complete response (pCR) rate (p = 0.019). On examining the correlation with prognosis, the low-PLR group was found to have significantly longer disease-free survival (p = 0.004) and overall survival (p = 0.032) than the high PLR group. Multivariate analysis also revealed that lymph node metastasis (p = 0.043, hazard ratio = 4.40) and a high PLR (p = 0.005, hazard ratio = 2.84) were independent, unfavorable prognostic factors.
  
  
  CONCLUSIONS
  For patients with breast cancer treated with NAC, a low PLR indicated high chemotherapy sensitivity, suggesting that PLR could serve as a predictive marker of the therapeutic effect of NAC.
authors.affiliation: Department of Surgical Oncology; Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Asano
authors.affiliation: Department of Surgical Oncology; Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kashiwagi
authors.affiliation: Department of Surgical Oncology; Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Onoda
authors.affiliation: Department of Surgical Oncology; Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Noda
authors.affiliation: Department of Surgical Oncology; Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hidemi
authors.initials: H
authors.lastname: Kawajiri
authors.affiliation: Department of Surgical Oncology; Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takashima
authors.affiliation: Department of Diagnostic Pathology; Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohsawa
authors.affiliation: Department of Physiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Kitagawa
authors.affiliation: Department of Surgical Oncology; Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Hirakawa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D018655:Lymphocyte Count; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D010976:Platelet Count
chemical_list: D015251:Epirubicin; D003520:Cyclophosphamide; D017239:Paclitaxel; D005472:Fluorouracil