The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients

Krenn-Pilko, S.; Langsenlehner, Uwe; Thurner, E.M.; Stojaković, Tatjana; Pichler, Martin; Gerger, Armin; Kapp, Karin S.; Langsenlehner, Tanja

doi:10.1038/bjc.2014.163

Cited by 250 publications

(234 citation statements)

References 49 publications

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“…Patients with a higher platelet-to-lymphocyte ratio experienced poorer survival times (15,16,21) and a larger number of infiltrated lymph nodes (22) compared with patients with a lower platelet-to-lymphocyte ratio. By contrast, Ulas et al (20) and Yao et al (18) reported that platelet-to-lymphocyte ratio does not significantly affect survival times in patients with breast cancer.…”

Section: Discussionmentioning

confidence: 99%

White blood cell and platelet indices as prognostic markers in patients with invasive ductal breast carcinoma

et al. 2016

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Abstract.A growing body of evidence suggests that oncogenesis is associated with systemic inflammation. The present study investigated white blood cell and platelet indices, whose values change during the inflammatory response, in women with invasive ductal breast carcinoma. Preoperatively obtained white blood cell and platelet counts from 53 patients with early breast cancer, who developed systemic metastases over a mean follow-up period of 65 months, were analyzed and compared with those of a matching control group formed of 37 patients with the same characteristics, who remained recurrence-free during the same time period. Patients who developed distant metastasis had a significantly higher mean platelet volume and lower neutrophil count than patients who did not present with distant metastasis. Furthermore, time to distant metastasis development was longer in patients with a lower mean platelet volume, whilst patients with a lower neutrophil count had a shorter systemic disease-free time interval. However, receiver operating characteristic curve analysis demonstrated that these parameters provided moderate accuracy in predicting which patients may develop distant metastasis. No differences were detected between patient groups regarding additional parameters. Patients who developed systemic disease during a mean follow-up period of 65 months were observed to have an increased mean platelet volume and decreased neutrophil count preoperatively. These results indicate that such parameters may be of prognostic value in patients with breast cancer. Studies with a larger number of patients are required to further investigate this hypothesis.

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Section: Discussionmentioning

confidence: 99%

White blood cell and platelet indices as prognostic markers in patients with invasive ductal breast carcinoma

et al. 2016

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“…Tumor cells possess the ability to manipulate platelet activity to optimize tumor growth, proliferation, survival and metastasis (29). Several studies have identified the association between a poor survival rate and elevated PLR in solid tumors (2,8,9,11,16,30). Szkandera et al revealed that an elevated PLR was significantly associated with a decreased time to recurrence and demonstrated a trend towards a decreased OS time in patients with stage II and III colon cancer that underwent curative resection (2).…”

Section: Stage IV ---------------------------------------------------mentioning

confidence: 99%

“…Notably, the scope and effects of an inflammatory reaction have always been assessed according to a number of biochemical markers, including the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR), which are inexpensive markers of systemic inflammation (7). Previous studies have indicated that elevated NLR or PLR suggested a poor prognosis for various types of cancer, including ovarian (8), breast (9,10), non-small cell lung (11), esophageal (12,13), gastric (7,14), hepatocellular (15) and CRC (2,(16)(17)(18). However, the current literature leaves certain questions unanswered.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer

et al. 2016

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Abstract. The present study aimed to investigate the independent prognostic values of the pre-operative neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in patients with colorectal cancer (CRC). The present study retrospectively analyzed the data of 216 patients with CRC from a single hospital. The clinicopathological characteristics of the patients were compared and prognostic factors were evaluated. NLR and PLR were associated with tumor differentiation status and the tumor diameter, respectively, and PLR was also associated with the primary tumor classification (T classification). Furthermore, NLR and PLR were positively associated with each other (R 2 =0.5368; P<0.0001). Univariate analyses indicated that stage II and III patients with a high NLR (≥4.98; P<0.001) or PLR (≥246.36; P<0.001) possessed a significantly poorer 5-year OS rate compared with those with a low NLR or PLR. Post-operative adjuvant chemotherapy improved the 5-year OS rate in patients with a high NLR or PLR. Multivariate analyses indicated that NLR and PLR were independent prognostic factors [NLR, relative risk (RR)=4.074 and P<0.001; PLR, RR=2.029 and P=0.029] in patients with CRC, and were associated with the T classification, lymph node metastasis and post-operative adjuvant chemotherapy response of patients. Additionally, the area under the curve (AUC) was 0.748 for NLR (95% CI, 0.684-0.804; P<0.0001) and 0.690 for PLR (95% CI, 0.623-0.751; P<0.0001). The RR and AUC indicated that NLR was the superior predictive factor in patients with CRC. In conclusion, the pre-operative NLR and PLR were significant independent prognostic factors in patients with CRC, and NLR was more effective as a prognostic marker compared with PLR. Adjuvant chemotherapy appeared to be more effective in CRC patients with a higher NLR or PLR.

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“…Simple biomarkers calculated as ratios of lymphocytes to other components of peripheral blood have been introduced during the last few years [15]. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-tomonocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) represent independent prognostic biomarkers across a spectrum of different primary tumors [16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Comparison of performance of composite biomarkers of inflammatory response in determining the prognosis of breast cancer patients

et al. 2017

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Abstract:In the present study, we determined complex indices of inflammatory activity and compared the performance of these indices as prognostic biomarkers in a cohort of breast cancer patients. All proposed composite biomarkers could be evaluated in 418 out of 474 patients in the cohort with complete data on peripheral blood cell count, urinary neopterin, albumin and C-reactive protein. Neutrophil-to-lymphocyte ratio, lymphocyteto-monocyte ratio, platelet-to-lymphocyte ratio, systemic inflammatory index, Glasgow prognostic index, modified Glasgow prognostic index, prognostic nutritional index and C-reactive protein/albumin ratio were calculated and further complex indices were proposed. Although a number of the investigated indices were significantly associated with survival in the univariate analysis, only age and stage, but none of the laboratory biomarkers or composite biomarkers, were significant predictors of survival in the whole group in the multivariate analysis. In patients evaluated before the start of the treatment, age, stage and urinary neopterin were significant predictors of survival. These results underscore the importance of neopterin as a prognostic biomarker in breast cancer.

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The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients

Cited by 250 publications

References 49 publications

White blood cell and platelet indices as prognostic markers in patients with invasive ductal breast carcinoma

White blood cell and platelet indices as prognostic markers in patients with invasive ductal breast carcinoma

Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer

Comparison of performance of composite biomarkers of inflammatory response in determining the prognosis of breast cancer patients

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