SynthesisFrontiers in oncology2026
Prognostic value of pretreatment neutrophil-to-lymphocyte ratio in breast cancer patients receiving neoadjuvant chemotherapy: a systematic review and meta-analysis.
Synthesis in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
Objective: This study examined whether pretreatment neutrophil-to-lymphocyte ratio (NLR) was associated with survival outcomes and treatment response in breast cancer patients treated with neoadjuvant chemotherapy. Methods: PubMed, EMBASE, Web of Science, and the Cochrane Library were searched for eligible studies published up to April 2026. Using Stata 18.0 and Review Manager 5.4, pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were synthesized to determine the relationship of pretreatment NLR with overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and pathologic complete response (pCR). Results: Fifty-six studies involving 16,539 patients were included. Elevated pretreatment NLR was significantly associated with worse OS (HR = 1.89, 95% CI 1.48-2.41; P<0.00001), DFS (HR = 1.79, 95% CI 1.45-2.23; P<0.00001), and RFS (HR = 1.89, 95% CI 1.17-3.05; P = 0.01), as well as a reduced likelihood of achieving pCR (OR = 0.50, 95% CI 0.40-0.64; P<0.00001). These findings remained stable in sensitivity analyses restricted to multivariable-adjusted estimates. Conclusion: Elevated pretreatment NLR was associated with poorer survival outcomes and lower pCR rates after NACT. However, because of substantial heterogeneity and inconsistent cutoffs, NLR should be viewed as a complementary marker requiring prospective validation rather than a routine prognostic factor.
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