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The elevated preoperative derived neutrophil-to-lymphocyte ratio predicts poor clinical outcome in breast cancer patients

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Tumor Biology

Abstract

Existing preclinical and clinical data suggest that the presence of a systemic inflammatory response plays a critical role in the progression of several solid tumors. The derived neutrophil-to-lymphocyte ratio (dNLR) represents an easily determinable marker of systemic inflammation and has been proposed as a potential prognostic marker. The present study was performed to validate and further clarify the prognostic relevance of an elevated pre-treatment dNLR in a large cohort of European breast cancer patients. Data from 762 consecutive female breast cancer patients treated from 1999 to 2004 were evaluated. Disease-free survival (DFS) and overall survival (OS) were assessed using the Kaplan–Meier method. To evaluate the prognostic relevance, univariate and multivariate Cox regression models were performed for each endpoint. Applying receiver operating characteristics (ROC) analysis, the optimal cutoff level for the dNLR was 3. In univariate analysis, a dNLR ≥3 was associated with poor DFS (hazard ratio (HR) 1.87, 95 % confidence interval (CI) 1.28–2.73, p = 0.001) and OS (HR 1.67, 95 % CI 1.07–2.63, p = 0.025). Multivariate analysis revealed a significant association between the elevated dNLR and poor DFS (hazard ratio (HR) 1.70, 95 % CI 1.09–2.65, p = 0.018) but did not show a significant association between the dNLR and OS (HR 1.54, 95 % CI 0.91–2.59, p = 0.106). The present study shows that the pre-treatment dNLR is an independent prognostic factor that could be useful for future individual risk assessment in breast cancer patients.

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Ethics statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The protocol has been approved by the Ethical Committee of the Medical University of Graz (approval number: EK 27-034 ex 13/14). As this is a retrospective nonintervention study, a formal consent is not required.

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Authors and Affiliations

  1. Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, Auenbruggerplatz 32, 8036, Graz, Austria

    Sabine Krenn-Pilko, Karin S. Kapp & Tanja Langsenlehner

  2. Division of Internal Medicine, Outpatient Department Graz, Graz, Austria

    Uwe Langsenlehner

  3. Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria

    Tatjana Stojakovic

  4. Division of Clinical Oncology, Department of Internal Medicine, Comprehensive Cancer Center, Medical University of Graz, Graz, Austria

    Martin Pichler & Armin Gerger

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  1. Sabine Krenn-Pilko
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Correspondence to Tanja Langsenlehner.

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Krenn-Pilko, S., Langsenlehner, U., Stojakovic, T. et al. The elevated preoperative derived neutrophil-to-lymphocyte ratio predicts poor clinical outcome in breast cancer patients. Tumor Biol. 37, 361–368 (2016). https://doi.org/10.1007/s13277-015-3805-4

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  • DOI: https://doi.org/10.1007/s13277-015-3805-4

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