342P - Baseline neutrophil to lymphocyte ratio correlates with tumor stage in locally advanced breast cancer patients

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Translational Research
Breast Cancer
Basic Principles in the Management and Treatment (of cancer)
Presenter Mariagrazia De Lisa
Citation Annals of Oncology (2014) 25 (suppl_4): iv110-iv115. 10.1093/annonc/mdu328
Authors M. De Lisa1, F. Ridolfi1, M. Pistelli1, A. Pagliacci1, N. Battelli1, Z. Ballatore1, A. Santinelli2, T. Biscotti2, R. Berardi1, S. Cascinu3
  • 1Universita' Politecnica Delle Marche, Ao Ospedali Riuniti Ancona, Italy, CLINICA DI ONCOLOGIA MEDICA, 60020 - ANCONA/IT
  • 2Ao Ospedali Riuniti-ancona, Università Politecnica Delle Marche, Ancona, Italy., Anatomia Patologica,, 60020 - ancona/IT
  • 3Università Politecnica Delle Marche, Ancona, Ao Ospedali Riuniti-ancona, , Italy., Clinica di Oncologia Medica, 60020 - ancona/IT



Neoadjuvant chemotherapy (NAC) is the standard of care for locally advanced breast cancers (BC). Based on previous studies high-lightening the potential role of baseline neutrophil to lymphocyte ratio (NLR) in predicting survival and mortality of patients with early breast cancer (BC), we aimed to investigate the association between pre-therapeutic NLR as a predictive marker for the pathologic response to NAC in patients with locally advanced breast cancer.


We reviewed the records of consecutive patients undergoing NAC for locally advanced BC (stage I-III) following surgery at our Institution between January 2007 and December 2012. The NLR was measured before NAC and the pathologic responses to NAC were evaluated. NLR is calculated as absolute neutrophil count divided by absolute lymphocyte count. The cut-off value of 3 was decided as the maximum (sensitivity + specificity) point according to receiver operating characteristics curves. The difference among variables was calculated by chi-square test. Disease-free survival (DFS) and overall survival (OS) were estimated using Kaplan-Meier method.


A total of 86 patients were eligible for analysis: 56% of patients showed higher pre-treatment NLR. Median age at diagnosis was 50 years (range 28-75). Patients with higher pretherapeutic NLR showed a significant association with lobular histology (12.8% vs 1.1; p = 0.01), pre-NAC lymph node involvement (48.8% vs 29%; p = 0.04) and deaths (15.1% vs 3.5%; p = 0.04). 25.6% of patients had a pathological complete response (pCR) to NAC. There was no significant correlation between pCR and NLR (p = 0.7). Breast cancers with negative Her-2 status or positive progesterone receptor, were less likely to have a pCR to NAC (p = 0.0002 and p = 0.02, respectively). Univariate survival analysis revealed that NLR was not associated with DFS (p = 0.42) or OS (p = 0.13).


Our results show that baseline NLR may play a potential role to assess tumor staging in locally advanced BC. Although baseline high pre-treatment NLR did not showed to be related with pCR, the trend of these patient with high pre-treatment NLR was worse than whom with lower NLR. In this setting, further validation and a feasibility study are required before it can be considered for clinical use.


All authors have declared no conflicts of interest.