Prognostic Value of Neutrophil-Lymphocyte Ratio Change After Short-Term Chemotherapy in De Novo Stage IV Breast Cancer Patients.

Abstract

We aimed to investigate whether the neutrophil-to-lymphocyte ratio (NLR) change after the first cycle of palliative chemotherapy can be a prognostic indicator in de novo stage IV breast cancer. We retrospectively reviewed 218 patients treated between January 1997 and December 2012 at Asan Medical Center, Seoul, Korea. The NLR change (ΔNLR = NLR after first cycle of chemo - initial NLR [iNLR]) was significantly inversely associated with breast cancer specific survival (BCSS) (p = 0.031). The 1-, 3-, and 5-year BCSS rates of patients in the increased NLR group were 78.4%, 37.8%, and 25.7%, and 88.9%, 55.6%, and 35.4%, respectively, in the other group (p = 0.035, 0.014, and 0.043, respectively). Multivariate analysis suggested that NLR was an independent prognostic factor (hazard ratio [HR], 1.748; 95% confidence interval [CI], 1.084-2.818). When patients were divided into four groups combining iNLR and ΔNLR, patients in high iNLR & increased NLR group (HR, 4.294; 95% CI, 1.586-11.629) had worst prognosis compared to patients in low iNLR & stationary or decreased NLR groups.