Hyangsook Choi1, Hany Noh1, In-Jeong Cho1, Seung-Taek Lim2, Airi Han3. 1. Department of Surgery, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju-si, Gangwon-do, 220-701, South Korea. 2. Department of Oncology, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju-si, Gangwon-do, 220-701, South Korea. 3. Department of Surgery, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju-si, Gangwon-do, 220-701, South Korea. airihan@yonsei.ac.kr.
Abstract
INTRODUCTION: Neoadjuvant treatment has been widely used for patients with advanced breast cancer, and pathological complete response (pCR) has been proposed as a surrogate marker. However, more than 50% of patients will not achieve pCR and an appropriate, practical prognostic marker is required for these patients. MATERIALS AND METHODS: A retrospective analysis of patients treated with neoadjuvant treatment for stage I-III disease was performed. Clinicopathological data including the neutrophil-to-lymphocyte ratio (NLR) were collected. NLRs were collected serially according to the treatment schedule. Changes in NLRs were calculated, of which the performance capacity as a prognostic factor was evaluated, and a Kaplan-Meier plot was developed and compared with the log rank test RESULTS: Changes in NLRs of each time points of 148 patients were used to assess performance capacity as a prognostic factor for invasive disease-free survival (IDFS), overall survival (OS) and distant disease-free survival (DDFS), and that of shortly prior to the third cycle treatment showed statistical significance. With a cut off value of 0.1258, patients could be divided into high- and low-risk of invasive disease recurrence. Kaplan-Meier curves were developed and the log rank test showed that patients in high-risk group after 2 cycles of neoadjuvant treatment were significantly correlated with worse survival outcomes than those in low-risk group. CONCLUSION: Changes in NLRs after neoadjuvant treatment showed statistically significant correlation with patient survival and could categorize patients into high- and low-risk groups. Larger, prospectively designed clinical trials are required to substantiate findings of this study.
INTRODUCTION: Neoadjuvant treatment has been widely used for patients with advanced breast cancer, and pathological complete response (pCR) has been proposed as a surrogate marker. However, more than 50% of patients will not achieve pCR and an appropriate, practical prognostic marker is required for these patients. MATERIALS AND METHODS: A retrospective analysis of patients treated with neoadjuvant treatment for stage I-III disease was performed. Clinicopathological data including the neutrophil-to-lymphocyte ratio (NLR) were collected. NLRs were collected serially according to the treatment schedule. Changes in NLRs were calculated, of which the performance capacity as a prognostic factor was evaluated, and a Kaplan-Meier plot was developed and compared with the log rank test RESULTS: Changes in NLRs of each time points of 148 patients were used to assess performance capacity as a prognostic factor for invasive disease-free survival (IDFS), overall survival (OS) and distant disease-free survival (DDFS), and that of shortly prior to the third cycle treatment showed statistical significance. With a cut off value of 0.1258, patients could be divided into high- and low-risk of invasive disease recurrence. Kaplan-Meier curves were developed and the log rank test showed that patients in high-risk group after 2 cycles of neoadjuvant treatment were significantly correlated with worse survival outcomes than those in low-risk group. CONCLUSION: Changes in NLRs after neoadjuvant treatment showed statistically significant correlation with patient survival and could categorize patients into high- and low-risk groups. Larger, prospectively designed clinical trials are required to substantiate findings of this study.
Entities:
Keywords:
Breast neoplasm; Lymphocyte; Neutrophil; Preoperative systemic treatment; Ratio