Neutrophil/lymphocyte ratio and overall survival in patients with breast cancer: a cohort study in a Latin-American hospital

Abstract

Background: Breast cancer is a disease of high mortality globally. Inflammatory markers have been proposed as prognostic indicators. Therefore, we seek to find an association between the neutrophil-lymphocyte ratio (NLR) and overall survival (OS) of patients with breast cancer in a Latin-American hospital. Methods: An observational, analytical, longitudinal survival study was conducted in 241 female patients with breast cancer, between 2012 and 2014. The dependent variable was OS, the independent variable was the NLR, and the intervening variables were age, clinical stage, and molecular subtype. The Kaplan–Meier method was applied to generate OS functions, and the Cox regression to find crude and adjusted hazard ratio (HR). Results: The mean age was 56.1 years and59.8% of patients had an NLR≥3.According to the Kaplan–Meier estimator, NLR≥3 (p<0.001), age>55 years (p=0.039), and clinical stage (p<0.001), were associated with a lower OS. In the multivariate analysis, the factors significantly associated to a lower OS were NLR≥3 (HRa: 2.00; CI 95%: 1.36–2.95), age>55 years (HRa: 1.64; CI 95%: 1.10–2.44), and clinical stage IV (HRa: 68; CI 95%: 2.28–20.20). Conclusions: The inflammatory marker NLR≥3 was independently associated with a lower OS. Additionally, advanced stage and older age were associated with a lower OS.