Abstract PS6-42: Prognostic value of neutrophil to lymphocyte ratio in patients with breast cancer in a Mexican population
Authors: Arroyave-Ramírez Andrés Mauricio , Varela-Santoyo Edgar , Soberanis-Piña Pamela Denisse , Buerba-Vieregge Hector Hugo , Motola-Kuba Daniel 
Published: February 2021

Abstract
Background: Inflammatory serum markers (IBM) have emerged as prognostic factors in solid tumors. In breast cancer (BC) in particular, an elevated neutrophil to lymphocyte ratio (NLR) has been linked to lower overall survival (OS) and disease-free survival (DFS), although a standard cutoff value has not been established. In Mexico there is no information regarding NLR as a prognostic marker in BC. The aim of the present study was to assess NLR as prognostic factor in BC patients in a Mexican population.
Methods: This single-center retrospective and descriptive study included patients, &gt;18 years old with histological diagnosis of BC who were treated at Medica Sur oncological center in Mexico City between January 2008 and December 2019. The patients were divided into two groups according to their NLR. NLR was calculated using the following formula: absolute neutrophil count / absolute lymphocyte count (mm3). NLR was considered as elevated (&gt;2), and as low (≤2) based on data from previous studies. The primary endpoint was OS. Statistical analysis was performed with SPSS v25. The associations between PNI and clinicopathologic characteristics were analyzed using Pearson's χ2 test. Kaplan-Meier and log-rank test methods were used for survival analysis. The prognostic value of the pre-treatment NLR was assessed by univariate and multivariate analysis. P&lt;0.05 was considered to indicate a statistically significant difference. This study was approved by our scientific and bioethical committee.
Results: A total of 110 patients were included in the final analysis. All patients had infiltrating ductal carcinoma; 18.2% were triple negative, 23.6% over-expressed HER 2 and around 51% had hormone receptor expression. 15.5% had metastatic disease. Median follow-up was 65 months. Mean NLR at diagnosis was 2.82 (SD 2.59). Mean NLR in patients with triple negative BC (TNBC) was significantly higher than in patients with non TNBC (p= 0.055), no other statistically significant associations were found between mean NLR and clinical characteristics. Median OS was not reached in two groups, but the 100 months OS was higher in NLR ≤2 group vs NLR &gt; 2 group (90 vs 78%) (p= 0.079). In univariate and multivariate analysis, triple negative histological subtype and elevated NLR were independent prognostic indicators of poor survival.
Conclusion: An elevated pretreatment NLR was an independent prognostic factor, associated with lower OS in patients with BC with local and advanced disease, although statistically significant association was not found. NLR is an accessible and minimally invasive marker with clinical value for evaluation of the prognosis of BC patients, especially in resource-limited settings.
Citation Format: Andrés Mauricio Arroyave-Ramírez, Edgar Varela-Santoyo, Pamela Denisse Soberanis-Piña, Hector Hugo Buerba-Vieregge, Daniel Motola-Kuba. Prognostic value of neutrophil to lymphocyte ratio in patients with breast cancer in a Mexican population [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-42.