Abstract PO2-06-05: Neutrophil-to-lymphocyte ratio (NLR) Predict the Outcome Significance for Primary Tumor Surgery in Patients with De novo stage Ⅳ Breast Cancer

Abstract

Abstract [Background] Although several prospective randomized trials have not shown a statistically significant difference in overall survival(OS),and quality-of-life(QOL) for the primary tumor surgery(PTS) of De novo stageⅣ breast cancer(BC), but more recent studies showed that could prolong OS in selected cases. This study respectively evaluated the value of neutrophil-to-lymphocyte ratio(NLR) as a biomarker for predicting the benefit of PTS in patients(pts) with stageⅣ BC. [Method] The clinical outcome and associated prognostic factors of pts with De novo stageⅣ BC were investigated. The decision of surgery option for primary tumor was shared with pts and determined by treating physicians according to the clinical symptoms. Laboratory blood examinations were performed before and after surgery or each treatment courses. The kinetics of peripheral blood lymph cell counts, NLR etc. were analyzed simultaneously. [Result] A total of 141 pts with stageⅣ BC were treated and enrolled from January 2004 to December 2022. 61 pts (Surgery group: SG) received and 80 pts (Non surgery group: NSG) not received PTS. The biological subtypes of primary BC included that 76 HR+(Luminal), 13 HR+Her2+(Luminal Her2), 29 Her2+ and 21 triple negative, respectively. The median PFS of SG and NSG were 88 ms and 30.3 ms, the median OS were 100.1 ms and 31.8 ms, respectively. Pts of SG who had high NLR ( >3) before the surgery showed a significant worse OS (p= < 0.0001)( Fig.1). And pts who responded to the systemic therapies prior to PTS for longer than 8.1 months showed a better OS(p=0.044). In contrast, pts of NSG who had a low ALC(≦1500/μL) at 6 months(p=0.026) and 1 year(p=0.007) after systemic therapies, and high NLR( >3) at 1 year(p=0001) had worse prognosis. [Summary] Our results suggested that pts with De novo stageⅣ BC who responded to the systemic therapies prior to PTS longer than 8.1 months, and who had a preoperative low NLR(≦3) might be benefit to PTS after the systemic therapies. And peripheral blood NLR before surgery may be a predictive marker for the indication of PTS in those pts. Further larger scale prospective studies are warranted. Citation Format: Rie Sugihara, Uhi Toh, Hidetaka Watanabe, Yuriko Katagiri, Shuntaro Matsushima, Okabe Mina, Yuko Takao, Nobutaka Iwakuma, Fumihiko Fujita. Neutrophil-to-lymphocyte ratio (NLR) Predict the Outcome Significance for Primary Tumor Surgery in Patients with De novo stage Ⅳ Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-06-05.