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Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer

  • Authors:
    • Bader Alshamsan
    • Mahmoud A. Elshenawy
    • Mohamed Aseafan
    • Nermin Fahmy
    • Ahmed Badran
    • Tusneem Elhassan
    • Adher Alsayed
    • Kausar Suleman
    • Taher Al‑Tweigeri
  • View Affiliations / Copyright

    Affiliations: Department of Medicine, College of Medicine, Qassim University, Buraydah, Qassim 52571, Kingdom of Saudi Arabia, Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Kingdom of Saudi Arabia
    Copyright: © Alshamsan et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 429
    |
    Published online on: July 11, 2024
       https://doi.org/10.3892/ol.2024.14562
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Abstract

The present study aimed to clarify the prognostic role of the pre‑treatment neutrophil‑to‑lymphocyte ratio (NLR) for the response to neoadjuvant chemotherapy (NAC) in locally advanced breast cancer (LABC). Due to conflicting results in currently available data, the specific focus of the present study was on evaluating the associations between the pre‑treatment NLR and the rate of achieving a pathological complete response (pCR) and survival outcomes. For the present study, data from a cohort of 465 consecutive patients with LABC who underwent NAC at King Feisal Specialist Hospital and Research Center (Riyadh, Saudi Arabia) between 2005 and 2014 were obtained from a prospective BC database and analyzed. Patients were stratified into two groups based on an optimal NLR cut‑off determined using the receiver operating characteristic curve. Logistic regression analyses were conducted to assess variables associated with pCR, and Cox regression analyses were used to assess variables associated with survival outcomes. The low pre‑treatment NLR group (≤2.2) was found to exhibit a higher likelihood of achieving a pCR (odds ratio, 2.59; 95% CI, 1.52‑4.38; P<0.001), along with higher 5‑year disease‑free survival (DFS) [75.8 vs. 64.9%; hazard ratio (HR), 0.69; 95% CI, 0.50‑0.94; P=0.02] and 5‑year overall survival (OS; 90.3 vs. 81.9; HR, 0.62; 95% CI, 0.39‑0.98; P=0.04) rates compared with those in the high NLR group (>2.2). Sub‑group analysis revealed that the observed significance in survival outcomes was driven by the triple‑negative BC (TNBC) subgroup. Patients with residual TNBC disease and a high pre‑treatment NLR were observed to have lower 5‑year DFS (44.4 vs. 75.0%; P=0.02) and 5‑year OS (55.9 vs. 84.5%; P=0.055) rates compared with those with residual TNBC disease and a low NLR. To conclude, data from the present study suggest that the pre‑treatment NLR can serve as a viable independent prognostic factor for pCR following NAC in patients with LABC and for survival outcomes, particularly for patients with TNBC.
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Alshamsan B, Elshenawy MA, Aseafan M, Fahmy N, Badran A, Elhassan T, Alsayed A, Suleman K and Al‑Tweigeri T: Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer. Oncol Lett 28: 429, 2024.
APA
Alshamsan, B., Elshenawy, M.A., Aseafan, M., Fahmy, N., Badran, A., Elhassan, T. ... Al‑Tweigeri, T. (2024). Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer. Oncology Letters, 28, 429. https://doi.org/10.3892/ol.2024.14562
MLA
Alshamsan, B., Elshenawy, M. A., Aseafan, M., Fahmy, N., Badran, A., Elhassan, T., Alsayed, A., Suleman, K., Al‑Tweigeri, T."Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer". Oncology Letters 28.3 (2024): 429.
Chicago
Alshamsan, B., Elshenawy, M. A., Aseafan, M., Fahmy, N., Badran, A., Elhassan, T., Alsayed, A., Suleman, K., Al‑Tweigeri, T."Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer". Oncology Letters 28, no. 3 (2024): 429. https://doi.org/10.3892/ol.2024.14562
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Spandidos Publications style
Alshamsan B, Elshenawy MA, Aseafan M, Fahmy N, Badran A, Elhassan T, Alsayed A, Suleman K and Al‑Tweigeri T: Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer. Oncol Lett 28: 429, 2024.
APA
Alshamsan, B., Elshenawy, M.A., Aseafan, M., Fahmy, N., Badran, A., Elhassan, T. ... Al‑Tweigeri, T. (2024). Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer. Oncology Letters, 28, 429. https://doi.org/10.3892/ol.2024.14562
MLA
Alshamsan, B., Elshenawy, M. A., Aseafan, M., Fahmy, N., Badran, A., Elhassan, T., Alsayed, A., Suleman, K., Al‑Tweigeri, T."Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer". Oncology Letters 28.3 (2024): 429.
Chicago
Alshamsan, B., Elshenawy, M. A., Aseafan, M., Fahmy, N., Badran, A., Elhassan, T., Alsayed, A., Suleman, K., Al‑Tweigeri, T."Prognostic significance of the neutrophil to lymphocyte ratio in locally advanced breast cancer". Oncology Letters 28, no. 3 (2024): 429. https://doi.org/10.3892/ol.2024.14562
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