Prognostic significance of derived neutrophil-lymphocyte ratio in Non-metastatic breast cancer

Abstract

Aim: Breast cancer is the most frequent cancer among women and the prognosis depends on the tumour biology and the treatment characteristics. Derived neutrophil-lymphocyte ratio (DNLR) a surrogate marker of cancer-associated inflammatory response is a cost-effective and simple prognostic parameter for breast cancer. There is a paucity of data regarding the prognostic significance of the DNLR in breast cancer in Indian subcontinent. The aim of the study is to investigate the prognostic role of DNLR in breast cancer in the Indian population. Materials and Methods: 497 patient data were evaluated retrospectively for evaluation of DNLR as a prognostic marker in non-metastatic breast cancer. With a median time to follow-up is 33.8 months (range: 9.6-64.7). A total number of the relapse were 115 and 36 deaths occurred. Results: The predicted 5-year relapse free and overall survival were 70% and 87.5% respectively. On multivariate analyses, factors significantly associated with high DNLR were duration of presentation >6 month, pre-menopausal status, higher T stage, high leucocyte count and the presence of hypoalbuminemia. There was a significant association between DNLR with RFS and OS with P < 0.05 and 0.003 respectively. Conclusion: This is the first study to investigate the prognostic role of DNLR in breast cancer in the Indian population. With combination with other prognostic markers, DNLR, a low-cost, reliable marker of inflammation may have potential utility in breast cancer prognosis.