ArticleESMO open2016
Neutrophil to lymphocyte ratio (NLR) for prediction of distant metastasis-free survival (DMFS) in early breast cancer: a propensity score-matched analysis.
Article in ESMO open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 4 of them syntheses that pooled it.
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Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Prognostic value of the pretreatment pan-immune-inflammation value in patients with head and neck squamous cell carcinoma: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- Prognostic significance of the pretreatment pan-immune-inflammation value in colorectal cancer patients: an updated meta-analysis.Frontiers in oncology · 2025Pooled it
- Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for breast cancer patients: An updated meta-analysis of 17079 individuals.Cancer medicine · 2019Pooled it
- Prognostic value of systemic inflammatory markers in ovarian Cancer: a PRISMA-compliant meta-analysis and systematic review.BMC cancer · 2018Pooled it
- Comparison of metabolic changes after neoadjuvant endocrine and chemotherapy in ER-positive, HER2-negative breast cancer.Scientific reports · 2021Trial
- Enhancing tourism management through big data: Design and implementation of an integrated information system.Heliyon · 2024Article
- Toxicity in the era of immune checkpoint inhibitor therapy.Frontiers in immunology · 2024Review
- Neutrophils in triple-negative breast cancer: an underestimated player with increasingly recognized importance.Breast cancer research : BCR · 2023Review
- Proposing a novel molecular subtyping scheme for predicting distant recurrence-free survival in breast cancer post-neoadjuvant chemotherapy with close correlation to metabolism and senescence.Frontiers in endocrinology · 2023Review
- Circulating circRNA: a social butterfly in tumors.Frontiers in oncology · 2023Review
- Lack of Prognostic Value of Pretreatment Neutrophil-to-Lymphocyte Ratio in Early Breast Cancer.Breast care (Basel, Switzerland) · 2022Article
- Surgical wounding enhances pro-tumor macrophage responses and accelerates tumor growth and lung metastasis in a triple negative breast cancer mouse model.Physiological reports · 2022Article
- The Innate Immune Microenvironment in Metastatic Breast Cancer.Journal of clinical medicine · 2022Review
- Article
- Body composition and immunonutritional status in patients treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC) for gastrointestinal peritoneal metastases: a prospective single-center analysis.Pleura and peritoneum · 2022Article
- Distant metastasis in oral squamous cell carcinoma: Does the neutrophil-to-lymphocyte ratio act as a surrogate of the host immune status?Oral oncology · 2022Article
- The 'Danse Macabre'-Neutrophils the Interactive Partner Affecting Oral Cancer Outcomes.Frontiers in immunology · 2022Review
- Predictors of distant metastases in sinonasal and skull base cancer patients treated with surgery.Oral oncology · 2021Article
- Neutrophil-to-lymphocyte ratio is associated with sensitivity to platinum-based chemotherapy and prognosis in patients with advanced serous ovarian carcinoma.Molecular and clinical oncology · 2021Article
- Neutrophil to Lymphocyte Ratio after Treatment Completion as a Potential Predictor of Survival in Patients with Triple-Negative Breast Cancer.Journal of breast cancer · 2021Article
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Authors and funding
15 authors.
Funding
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Abstract
objectiveTo assess the correlation between presurgery neutrophil to lymphocyte ratio (NLR) and distant metastasis-free survival (DMFS) in patients with early breast cancer.
designRetrospective analysis.
participants300 Caucasian patients with early (T1-2, N0-1, non-metastatic) breast cancer who were followed from July 1999 to June 2015 at our Institution.
main outcome measuresDistant metastasis-free survival (DMFS).
resultsOf whole populations (300 patients), 134 and 166 patients were grouped as low and high NLR, respectively, on the basis of NLR value of 1.97, as established by receiver operating characteristic (ROC) curve analysis (area under curve (AUC)=0.625, p=0.0160). The DMFS rates for 1, 3, 6, 9, 12 and 15 years were better in low NLR patients (100%, 98.9%, 91.7%, 82.7%, 82.7%, 82.7%, respectively), than in high NLR patients (99.4%, 94.3%, 84.5%, 69.2%, 66.0%, 51.4%, respectively), with a statistically significant association. On multivariate analysis, premenopausal status (HR=2.78, 95% CI 1.36 to 5.67, p=0.0049), N1 stage (HR=2.31, 95% CI 1.16 to 4.60, p=0.0167) and a high NLR value (HR=2.64, 95% CI 1.22 to 5.638, p=0.0133) were shown to be independent prognostic factors related to poor recurrence rate. To avoid risk of confounding bias, a propensity score-matched analysis was performed and multivariate analysis according to the Cox model confirmed premenopausal status (HR=2.94, 95% CI 1.25 to 6.93, p=0.0136), N1 stage (HR=2.77, 95% CI 1.25 to 6.12, p=0.0117) and high NLR values (HR=2.52, 95% CI 1.11 to 5.73, p=0.0271), as independent prognostic variables of worse outcome.
conclusionsThis is the first study, to our knowledge, to show a significant correlation between high NLR and worse prognosis in Caucasian patients with early breast cancer by means of propensity score-matched analysis. Further well designed prospective trials with a large sample size are needed to verify our findings and to justify introducing NLR assessment in clinical practice for prediction of cancer recurrence.
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