title: Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic factors in non-metastatic breast cancer patients from a Hispanic population.
abstract: BACKGROUND
  High values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been associated with poor prognosis in certain tumors. Nevertheless, few data exist regarding these prognostic variables in breast cancer patients from Hispanic populations. In this study, we aimed to determine the prognostic value of these two estimates and to establish the best cutoff to categorize patients according to their risk.
  
  
  METHODS
  We retrospectively reviewed 172 consecutive breast cancer patients treated in our center. Pre-treatment NLR and PLR, as well as clinical variables were collected from medical records. Univariate and multivariate Cox regression analyses were performed to assess the relationship between NLR, PLR, overall survival (OS) and disease free survival (DFS), adjusted for potential confounders. The best cut-off point was determined based on the maximization of the Log-rank test statistic.
  
  
  RESULTS
  Median follow-up time was 71.3 months. The optimal cut-off for NLR and PLR was 3 and 250, respectively. In univariate analysis, a NLR 3 was associated with poor DFS (Hazard Ratio (HR): 3.92; 95% Confidence Interval (CI): 1.98-7.77; p < 0.001) and reduced OS (HR: 4.20; 95% CI: 2.10-8.38; p < 0.001). Similarly, a PLR 250 was associated with worse DFS (HR: 5.01; 95% CI: 2.33-11.1; p < 0.001) and poorer OS (HR: 5.35; 95% CI: 2.43-11.76; p < 0.001). However, after adjustment for potential confounders, only the PLR was independently associated with worse outcomes.
  
  
  CONCLUSIONS
  A NLR greater than 3 and a PLR greater than 250 were associated with worse OS and DFS in Hispanic patients with breast cancer.
authors.affiliation: Departamento de Oncología Médica., Hospital San Juan de Dios, San José, Costa Rica.|Departamento de Farmacologia, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica.
authors.forename: Allan
authors.initials: A
authors.lastname: Ramos-Esquivel
authors.affiliation: Departamento de Oncología Médica., Hospital San Juan de Dios, San José, Costa Rica.
authors.forename: Luis
authors.initials: L
authors.lastname: Rodriguez-Porras
authors.affiliation: Departamento de Patología, Hospital San Juan de Dios, San José, Costa Rica.
authors.forename: Juan
authors.initials: J
authors.lastname: Porras
mesh_terms: D000328:Adult; D000368:Aged; D001792:Blood Platelets; D001943:Breast Neoplasms / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018655:Lymphocyte Count; D008875:Middle Aged; D009504:Neutrophils; D010976:Platelet Count; D012189:Retrospective Studies; D015996:Survival Rate; D044465:White People
keywords: Breast cancer; lymphocyte; neutrophil; platelet; prognosis