Prognostic Value of the Neutrophil-Lymphocyte Ratio in Triple Negative Breast Cancer Patients

Objective. To assess the prognostic value of the neutrophil-lymphocyte ratio (NLR) in a cohort of triple-negative breast cancer patients (TNBC) treated in a regional cancer center. Methods. The electronic medical records of 214 consecutive patients treated with surgery, chemotherapy, and radiotherapy between 2006 and 2016 were reviewed. The prognostic significance of the NLR for disease-free survival (DFS) and overall survival (OS) was examined in relation to clinical and treatment-related factors. Overall survival and DFS were assessed using the Kaplan-Meier method; Cox semi-parametric regression modelling was used for multivariate analysis. Results. Ninety patients were eligible; median follow-up was 45.6 months (range, 6-105 months). The 3-year OS rate was 77.9% and the 5-year OS rate 61.7%. Patients with an NLR of <= 1.7 had significantly better DFS (P=0.029) than patients with an NLR>1.7; OS approached statistical significance (P=0.055). When treatment-related factors - significant on univariate analysis - were entered into the multivariate model, only nodal status N2/N3 remained as significant for DFS (P=0.0078) and advanced T-stage (T3, T4) significant for OS (P=0.014). Conclusion. While NLR is associated with survival in TNBC patients on univariate analysis, the prognostic value of NLR is likely due to its association with other clinicopathological factors.