Abstract 19P
Background
Breast cancer is one of the leading causes of death worldwide. Tumor vascularity and immune disturbance are one of the hallmarks of cancer and related with patients’ survival. Here we report how tumor vascularity assessed by Hounsfield Units(HU) on patients’ computed tomography(CT) and hosts’ immunologic environment represented by serum neutrophil to lymphocyte ratio(NLR) played and affected patients’ survival.
Methods
Materials and methods: Female patients with breast cancer who got preoperative treatment from 2008 to 2018 at Wonju Severance Hospital, Wonju, Korea, were included. Clinicopathological data were collected. Maximum HU of tumor and aorta on CT and their ratio(TAR) were calculated. Peripheral complete blood cell counts were collected and NLR were calculated. Patients were categorized according to the cutoff values retrieved from the receiver operating characteristic curve and Kaplan-Meier curves were generated to compare overall and distant disease free survival.
Results
The final cohort included 740 patients with mean age, 54.3±11.3 (22-89) years old. TAR was 0.347±0.108(range, 0.062-1.114) and NLR was 2.29 ±1.53 (range, 0.61 – 10.47). Cut-off values for TAR and NLR were 0.27 and 1.61, respectively. Both high TAR and NLR groups showed significantly worse recurrence free-interval (p<0.001, p=0.002 respectively), distant recurrence free-interval (p<0.001, p=0.034, respectively) and overall survival(p=0.002, p=0.007 respectively). Further analysis was done on TAR and NLR combined groups and only patients with high TAR and NLR showed worse prognosis than others. Any group with just one worse factor, either TAR or NLR, did not show worse prognosis than patients with higher value in TAR and NLR(p<0.001).
Conclusions
Increased HU on CT representing tumor aspect and NLR reflecting immune status of hosts influenced patients survival with significance. This impact was magnified when patients had increased value of both factors, suggesting a close relationship between tumor vascularity and patients’ immune cells.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.