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. 2016 Mar 31:6:81.
doi: 10.3389/fonc.2016.00081. eCollection 2016.

The Pretreatment Neutrophil/Lymphocyte Ratio Is Associated with All-Cause Mortality in Black and White Patients with Non-metastatic Breast Cancer

Joseph Rimando  1 , Jeff Campbell  2 , Jae Hee Kim  2 , Shou-Ching Tang  3 , Sangmi Kim  3
Affiliations

The Pretreatment Neutrophil/Lymphocyte Ratio Is Associated with All-Cause Mortality in Black and White Patients with Non-metastatic Breast Cancer

Joseph Rimando et al. Front Oncol. .

Abstract

The pretreatment neutrophil/lymphocyte ratio (NLR), derived from differential white blood cell counts, has been previously associated with poor prognosis in breast cancer. Little data exist, however, concerning this association in Black patients, who are known to have lower neutrophil counts than other racial groups. We conducted a retrospective cohort study of 236 Black and 225 non-Hispanic White breast cancer patients treated at a single institution. Neutrophil and lymphocyte counts were obtained from electronic medical records. Univariate and multivariate Cox regression models were used to determine hazard ratios (HRs) and 95% confidence intervals (95% CIs) of all-cause mortality and breast cancer-specific mortality in relation to pretreatment NLR. Overall, there were no associations between an elevated pretreatment NLR (NLR ≥3.7) and all-cause or breast cancer-specific mortality. Among patients without metastasis at the time of diagnosis, an elevated pretreatment NLR was independently associated with all-cause mortality, with a multivariable HR of 2.31 (95% CI: 1.10-4.86). Black patients had significantly lower NLR values than White patients, but there was no evidence suggesting racial heterogeneity of the prognostic utility of NLR. Pretreatment NLR was an independent predictor of all-cause mortality but not breast cancer-specific mortality in non-metastatic breast cancer patients.

Keywords: Black patients; White patients; all-cause mortality; breast cancer; neutrophil/lymphocyte ratio.

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Figures

Figure 1
Figure 1
Median NLR levels by tumor stage, according to race. Test for linear trend was done with univariate linear regression and tests by stage were done using the Mann–Whitney test.
Figure 2
Figure 2
The hazard ratio and p-value for all-cause mortality in patients above or equal versus below the corresponding NLR cutoff displayed on x-axis.
Figure 3
Figure 3
Overall survival by high NLR (≥3.7) versus low NLR (<3.7) among Black and White breast cancer patients. p-Values are for the log-rank test.
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