THE NEUTROPHIL-TO-LYMPHOCYTE RATIO IS AN IMPORTANT PROGNOSTIC FACTOR IN BREAST CANCER:A SYSTEMATIC REVIEW AND META-ANALYSIS.

Samantha Karlla Lopes de Almeida Rizzi, Cinira Assad Simão Haddad, Patrícia Santolia Giron, Roberta Pitta Costa Luz, Thais Lúcia Pinheiro, Patrícia Vieira Guedes Figueira, Afonso Celso Pinto Nazario, Gil Facina

Institution: Universidade Federal de Uberlândia

“Background: Inflammation may play an independent role in breast cancer progression. Recently, an elevated neutrophil to lymphocyte ratio (NLR) has been reported as indicative of a poor prognosis in overall survival (OS) and disease-free-survival (DFS). We conducted a meta-analysis to determine the association between NLR and the clinical outcome of patients with breast cancer.Methods: We performed comprehensive searches of electronic databases (PubMed and EMBASE) to identify studies that evaluated the prognostic impact of pretreatment NLR in breast cancer patients. The end points were overall survival (OS), disease-free survival, and clinicopathologic parameters. A meta-analysis using random-effects models was performed to calculate hazard ratios (HRs) or odds ratios with 95 % confidence intervals (CIs). Results: A total of sixteen published studies (including 9766 patients) were eligible. All studies were retrospective cohorts and published between 2012 and 2015. Of the reports selected for further evaluation, seven investigated the prognostic role of NLR for OS, and eight for recurrence free survival (RFS). A higher NLR had a higher all-cause mortality HR of 0.26 (95% CI = 0.19-0.35, p<0.0001), with a I²=52% (PH=0.08) than those with a low NLR. Conclusion: This meta-analysis suggests that elevated NLR is associated with poor survival in breast cancer. The NLR is an independent prognostic factor that and might be an available instrument that could be used in daily clinical practice to help therapeutic intervention of tumor subtypes in breast cancer.

Keywords: Breast cancer. Inflammation. Neutrophil to lymphocyte ratio. Prognosis.”