Immediate Postoperative Inflammation Is an Important Prognostic Factor in Breast Cancer

Abstract

Objective: Inflammation is associated with worse outcomes in cancer. Operations induce an acute inflammatory response and could impact the clinical outcomes in breast cancer. The neutrophil-lymphocyte ratio (NLR) is a well-known indicator of inflammation. We investigated the prognostic significance of perioperative inflammation with the NLR in breast cancer. Methods: We reviewed the clinical and pathological records of women diagnosed with invasive breast carcinoma at the Samsung Medical Center between 2000 and 2010. The NLR levels in the immediate preoperative period and the postoperative periods (1 week and 1 month) were assessed. Results: The NLRs of a total of 3,116 breast cancer patients were examined. In the univariate analysis, the NLR in postoperative week 1, total mastectomy, the presence of lymphovascular invasion, a higher nuclear grade and pathologic TNM stage, and negative hormone receptor and subtypes were factors associated with poor disease-specific survival. The NLR in postoperative week 1 remained a significant prognostic factor in the multivariate analysis. A cutoff level of 5.2, determined by the minimum p value approach, was found to be a significant level for discriminating the impact on breast cancer-specific mortality (p = 0.0116 adjusted by the Bonferroni correction). Conclusions: Immediate postoperative inflammation is an important prognostic marker in breast cancer patients.

Prognostic role of pretreatment neutrophil to lymphocyte ratio in breast cancer patients

“…3 ), with a significant heterogeneity ( I 2 = 78%). Similarly, stability of the pooled result was influenced by the study by Lee et al [ 16 ] in sensitivity analysis (Supplementary Figure 3). As there were too few studies in this pooled analysis, we did not perform subgroup analysis and publication bias analysis.…”

Inflammatory Blood Markers as Prognostic and Predictive Factors in Early Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

“…Most of the studies evaluating IBM as prognostic factors studied Asian-based populations [ 9 , 14 , 16 , 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ], where use of anti-cancer drugs, particularly trastuzumab, is inconsistently reported, inducing heterogeneity in survival expectations. This demographic variable could be associated with specific molecular and pharmacological features that can induce differences in toxicity and efficacy profiles.…”

Precancerous niche (PCN), a product of fibrosis with remodeling by incessant chronic inflammation

“…There is a renewed interest in assessing the contribution of inflammatory processes as prognostic variables in cancers [46]. The sequences (1) pathogenic stimulus, (2) chronic inflammation, (3) fibrosis and (6) normal to cancer cell transition are seen in viral hepatitis-associated liver cancer [47].…”