Abstract P3-07-09: The preoperative systemic inflammatory response as a strong prognostic factor in breast cancer patients

Abstract

Abstract Background: Recent reports show that the preoperative systemic inflammatory response status correlate with the survival rate in cancer patients. The Prognostic Nutritional Index (PNI), Controlling Nutritional Status (CONUT), Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) score are used as screening tools for immunonutritional status and reported to be a predictor of postoperative recurrence in patients with various gastrointestinal cancers. However, the clinical importance of these scoring in breast cancer has not been fully elucidated. The aim of this study is to investigate the clinical impact of preoperative systemic inflammatory response on long-term survival of breast cancer patients. Patients and Methods: We retrospectively analyzed 653 consecutive stage I-III breast cancer patients who were treated from January 2002 to December 2013. The PNI score was calculated as 10 x serum albumin (g/dl) + 0.005 x total lymphocyte count (per mm3). The CONUT score is calculated from three parameters, serum albumin, cholesterol, and total lymphocytes count. The patients were divided into two groups according to each value. The uni- and multivariate Cox regression analyses were performed to evaluate the prognositic value of the systemic inflammatory response in breast cancer. Results: The malnutritional or high SIR status was observed in 170 (26%),131 (20%), 119 (18%) and 226 (35%) patients as low-PNI, high-CONUT, elevated NLR and PLR, respectively. The relapse-free survival (RFS) and overall survival (OS) rates were significantly lower in the low-PNI group (RFS: p<0.0001, OS: p<0.0001) and high-CONUT group (RFS: p=0.0009, OS: p=0.0018). No significant association was found between NLR, PLR and prognosis. In the multivariate analysis, low-PNI was the independent prognostic factors for OS (HR4.71, p=0.0023). In the subset analysis, the low-PNI group showed poor prognosis especially in the postmenopausal, hormone receptor negative patients. The low-PNI also had poorer prognosis in post-recurrence survival. Conclusions: The preoperative systemic inflammatory response, especially PNI, is a strong independent predictor of long-term survival among breast cancer patients. Citation Format: Nami Yamashita, Sayuri Akiyoshi, Eiki Sano, Tomoko Shigechi, Yuichi Hisamatsu, Eriko Tokunaga, Eiji Oki, Masaki Mori. The preoperative systemic inflammatory response as a strong prognostic factor in breast cancer patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-07-09.