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Pretreatment neutrophil/lymphocyte, platelet/lymphocyte, lymphocyte/monocyte, and neutrophil/monocyte ratios and outcome in elderly breast cancer patients

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Abstract

Purpose

Several studies have found an association between peripheral inflammatory cells and outcome. However, no study has explored their impact specifically in elderly patients. We have retrospectively examined pretreatment peripheral neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), and neutrophil/monocyte ratio (NMR) in 113 elderly breast cancer patients and correlated our findings with disease-free survival (DFS) and overall survival (OS).

Methods

All patients ≥ 65 years diagnosed from 2004 to 2018 with locally advanced breast cancer were included and classified as high vs low NLR, PLR, LMR, and NMR based on previously identified cutoffs. Estimated 1-, 3-, and 5-year DFS and OS were compared by Chi square analysis.

Results

Among 104 evaluable patients, only PLR was significantly associated with estimated 3-year DFS (85.1% vs 63.6%; P = 0.04) and OS (89.3% vs 68.1%; P = 0.03). Among 69 patients with three or more years of follow-up, PLR (P = 0.05), absolute lymphocyte count (ALC) (P = 0.01), polychemotherapy (P = 0.04), number of comorbidities (P = 0.02), polypharmacy (P = 0.005), and clinical stage (P = 0.03) were associated with 3-year DFS. Polypharmacy (OR 4.9; P = 0.02) and ALC (OR 4.6; P = 0.04) retained their significance in the multivariate analysis.

Conclusions

We have found an association between low PLR and longer DFS in elderly breast cancer patients that is in line with findings in patients with a wider range of ages. Our findings on NLR contrast with those of other studies, indicating a potential differential effect in elderly patients. In addition, the effect of polypharmacy on outcome in elderly patients warrants further investigation.

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Funding

This study received no outside funding.

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Authors and Affiliations

  1. Hospital Universitario de Fuenlabrada, Madrid, Spain

    B. Losada, J. A. Guerra, D. Malón & L. Rodriguez

  2. Escuela Internacional de Doctorado Universidad Rey Juan Carlos, Móstoles, Spain

    B. Losada

  3. Fundación Hospital Alcorcón, Madrid, Spain

    C. Jara

  4. Hospital Universitari Dr. Josep Trueta, ICO Girona, Girona, Spain

    S. Del Barco

Authors
  1. B. Losada
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  2. J. A. Guerra
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  3. D. Malón
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  4. C. Jara
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  5. L. Rodriguez
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  6. S. Del Barco
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Correspondence to B. Losada or S. Del Barco.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Ethics and Clinical Research Committees of Fuenlabrada University Hospital and Alcorcon Foundation and was, therefore, performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Losada, B., Guerra, J.A., Malón, D. et al. Pretreatment neutrophil/lymphocyte, platelet/lymphocyte, lymphocyte/monocyte, and neutrophil/monocyte ratios and outcome in elderly breast cancer patients. Clin Transl Oncol 21, 855–863 (2019). https://doi.org/10.1007/s12094-018-1999-9

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  • DOI: https://doi.org/10.1007/s12094-018-1999-9

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