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Abstract
We aimed to investigate the correlation between neutrophil-to-lymphocyte ratio (NLR) and pathologic complete response (pCR) and survival outcomes in human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients who received neoadjuvant chemotherapy. The baseline NLR was evaluated in non-metastatic, HER2-negative breast cancer patients who received neoadjuvant chemotherapy. Baseline NLR was calculated as absolute neutrophil per lymphocyte count from pre-treatment blood samples. Any value ≥ 2.74 was considered to be a high NLR. In the 1,097 patients studied, 272 (24.4%) had high NLR and 825 (75.6%) had low NLR. The high NLR was an independent factor for pCR (OR 0.595; 95% CIs 0.398–0.890; P = 0.011). Furthermore, high NLR was a significant independent parameter affecting DFS (HR 2.298; 95% CIs 1.691–3.124; P < 0.001) and OS (HR 1.905; 95% CIs 1.167–3.108; P = 0.010). Regardless of the baseline NLR, survival outcomes were excellent in patients who achieved pCR, but high NLR was associated with worse survival for patients with residual invasive disease. Our study showed that NLR was predictive for treatment response and a prognostic factor in patients with HER2-negative breast cancer who received neoadjuvant chemotherapy. Moreover, we identified that high NLR was associated with poor survival outcomes in patients who did not achieve pCR.
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1 Yonsei University College of Medicine, Department of Surgery, Gangnam Severance Hospital, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
2 Yonsei University College of Medicine, Department of Pathology, Gangnam Severance Hospital, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
3 The Catholic University of Korea, College of Medicine, Department of Surgery, St. Mary’s Hospital, Seoul, Republic of Korea (GRID:grid.411947.e) (ISNI:0000 0004 0470 4224)
4 Yonsei University College of Medicine, Department of Surgery, Severance Hospital, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)