Usefulness of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as a predictor of disease-free survival in breast cancer: A cross-sectional study

Abstract

Background: The relationship between neutrophil-lymphocyte ratio (NLR) with outcome is a complex issue. A high NLR reflects systemic inflammation. This study aimed to estimate the relationship between NLR, and platelet-lymphocyte ratio (PLR) in disease-free survival (DFS). Methods: This was a cross-sectional study in which we reviewed the patient files of 102 patients with breast cancer treated at the Babylon Oncology Center from January 2009 to September 2014, who had follow-up for at least 36 months. The following data were collected from patient files: age, diagnosis date, date of recurrence and/or metastasis, follow-up, histological tumor type, tumor size, node metastasis stage, histological differentiation degree, estrogen and/or progesterone receptor expression, HER2 neu status, and metastasis site. Results: The mean age of patients was 50.4 ± 11.7 years and lowest period of follow up was 40 months. Longest DFS was 62 months, with 5 years DFS in 52.5% of patients. Stage N0 was associated with a significantly higher DFS compared to stage N1. Isolated local recurrence was seen in 15% of patients and combined local recurrences with distant metastasis was observed 37%. NLR had the highest discrimination ability to predict recurrence and distant metastasis. Conclusion: An increase in NLR was associated with poor DFS, and it can therefore be a predictive and prognostic factor. NLR’s established prediction model warrants further investigation.