Abstract P3-08-12: Prognostic relevance of neutrophil-to-lymphocyte ratio (NLR) in young women with breast cancer (BC)
Notice bibliographique
Résumé
Abstract Background: Many studies suggest that a high NLR prior to systemic treatment is an adverse prognostic marker for BC but its role in women ≤ age 40 in general, and in those with pregnancy associated BC (PABC) in particular is unknown. We investigated whether the NLR is independently prognostic for recurrence-free survival (RFS) in a prospective database of young BC patients. Methods: A prospective database of women ≤40 years of age diagnosed with BC from 02-2008 to 01-2015 was analyzed. Data regarding age, stage at diagnosis, pathology, treatment and clinical outcomes were available; the NLR was abstracted from the patients' medical record retrospectively with all values obtained post-diagnosis and prior to systemic therapy. The Kaplan-Meier method was used to estimate time-to-event outcomes, with a primary outcome of RFS. Insufficient events had occurred to analyze overall survival. Univariable Cox proportional hazards regression models were used to evaluate factors that were potentially prognostic for RFS; a subsequent multivariable Cox proportional hazards model adjusted for nodal involvement, PABC status and tumor size. All tests were two-sided and statistical significance was defined as a p-value ≤0.05. Results: Of 233 women in the database, 208 had a NLR and outcomes available for analysis. The mean age of patients was 35.1 and 24% (n=66/233) had PABC (BC diagnosed during pregnancy or ≤ 24 months postpartum); the median size of their tumors was 2.8 cm (range 0.1 cm – 19.0 cm) and 48% (n=102/211) were node positive. The majority of women had hormone receptor positive (92%; n=206/223) and HER2 negative 75% (n=160/212) disease, 50% (n=112/223) were treated with breast conserving surgery, 61% (n=142/233) received adjuvant radiotherapy and 83% (n=184/223) received adjuvant chemotherapy. With a median follow-up of 41 months, 16 patients (7%) experienced a local recurrence and 25 (11%) had distant recurrent disease. A higher NLR was prognostic for an adverse RFS in both uni- and multi-variable models (Table). The neutrophil count, individually, was also prognostic for adverse RFS but the lymphocyte count was not. The findings for patients with PABC and non-PABC were similar (interaction tests >0.05). Prognostic association between NLR and RFSVariableNumber of patients (total N=223)Univariable HR (95% CI)P valueMultivariable HR (95% CI)P valueSize ( /cm)1981.1 (0.9 - 1.2)0.261.0 (0.5 - 1.9)0.99Node positive (yes vs no)2042.1 (0.9 - 4.8)0.0912.6 (1.0 - 6.7)0.050PABC (yes vs no)2232.2 (1.0 - 4.8)0.0481.8 (0.8 - 4.3)0.17Log[NLR] ( /unit)2082.6 (1.3 - 5.0)0.0062.5 (1.2 - 5.0)0.006Log[neutrophils] ( /unit)2082.9 (1.2 - 7.3)0.023--Log[lymphocytes] ( /unit)2080.54 (0.16 - 1.8)0.31-- Conclusions: A higher NLR is prognostic for adverse RFS in our cohort of women ≤40 years of age with BC, including those with PABC. In our study, a higher neutrophil count drives the prognostic effects of NLR, suggesting an inflammatory state. If our results are confirmed in larger data sets, these findings may warrant the investigation of anti-inflammatory agents in the treatment of young women with BC. As BC in this age group has a worse prognosis than BC in older women, the potential benefit of anti-inflammatory agents may be easier to observe in this population. Citation Format: Jerzak KJ, Zhu S, Nofech-Mozes S, Pond G, Warner E. Prognostic relevance of neutrophil-to-lymphocyte ratio (NLR) in young women with breast cancer (BC) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-08-12.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».