title: An increased neutrophil-to-lymphocyte ratio predicts poorer survival following recurrence for patients with breast cancer.
abstract: The aim of the present study was to evaluate the association between changes in the neutrophil-to-lymphocyte ratio and the survival rate, as well as tumor subtype, in recurrent breast cancer. Patients with recurrent breast cancer following surgery were included in this study. NLR was calculated and compared between two time points: Pre-treatment and recurrence. The associations between the longitudinal NLR change, the NLR at the time of recurrence and overall survival following recurrence (OSrec) were evaluated. A total of 89 patients were evaluated. NLR increased by 0.59 at recurrence, as compared with the initial treatment (P<0.05). The triple negative (TN) type demonstrated 4.59 in NLR, which was the highest among the four subtypes at the time of recurrence (P<0.05). The highest change (an increase of 2.0) was observed in TN type cancer (P<0.05). Patients with high NLR upon recurrence demonstrated significantly shorter OSrec rates (P<0.05). On the other hand, patients with an NLR increased by more than a third quartile demonstrated a shorter OSrec rate (P=0.06). When adjusted by covariates, the NLR and tumor subtype were determined to be associated with OSrec (P<0.05). Therefore, an increased NLR predicts survival, even in patients with recurrent breast cancer, and the NLR is potentially useful as an inflammation marker for TN breast cancer.
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Iwase
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Sangai
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sakakibara
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Junta
authors.initials: J
authors.lastname: Sakakibara
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Ishigami
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Shouko
authors.initials: S
authors.lastname: Hayama
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Nakagawa
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Masuda
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tabe
authors.affiliation: Department of General Surgery, Chiba University Hospital, Chiba 2608677, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagashima
keywords: breast cancer; neutrophil-to-lymphocyte ratio; overall survival after recurrence; triple negative breast cancer