Table 1.
Characteristics of the studies related to neutrophil-to-lymphocyte ratio.
| References | Country | Study period | Cancer type | Median age (ys) | No. patients low/high NLR | Treatment | Follow-up | Significance of NLR |
|---|---|---|---|---|---|---|---|---|
| Noh et al. (32) | Korea | 2000–2010 | Luminal A/B, HER2-enriched, TNBC |
50 |
n = 442 NLR < 2.5 (n ≤ 327) NLR ≥ 2.5 (n = 115) |
NR | 5.9 ys | High NLR indicates lower survival rate (p = 0.009). |
| Koh et al. (33) | Korea | 2002–2010 | ER/PR-positive, HER2-enriched |
44 |
n = 157 NLR ≤ 2.25 (n = 91) NLR > 2.25 (n = 66) |
Surgery, NCT | 21 mo | Univariate analysis indicates high NLR related to lower RFS (p = 0.001) and OS (p < 0.001). |
| Yao et al. (34) | China | 2009–2011 | Luminal A/B, ER/PR-positive, HER2-enriched, TNBC |
50 |
n = 608 NLR = 2.57; NLR > 2.57 |
Surgery | 5.9 ys | High NLR indicates lower 5-year OS. |
| Pistelli et al. (35) | Italy | 2006–2012 | TNBC | 53 |
n = 90 NLR ≤ 3 (n = 73) NLR > 3 (n = 17) |
NR | 53.8 mo | Multivariate analysis indicates high pretreatment NLR is correlated with poor DFS (p = 0.03) and OS (p = 0.01). |
| Ulas et al. (36) | Turkey | 2009–2014 | HER2-enriched | 51.4 |
n = 187 NLR < 2.38 (n = 119) NLR > 2.38 (n = 68) |
Adjuvant transtuzumab | 26 mo | High pretreatment NLR indicates shorter DFS. |
| Jia et al. (37) | China | 2000–2010 | ER /PR-positive, HER2-enriched, TNBC |
47 |
n = 1,570 NLR > 2 (n = 804) NLR ≤ 2 (n = 766) |
NCT, surgery | 79 mo | Multivariate analysis indicates low NLR is related to superior DFS (p = 0.004) and (p = 0.022). |
| Bozkurt et al. (38) | Turkey | 2002–2013 | TNBC | 50 |
n = 85 NLR ≤ 2 (n = 33) NLR > 2 (n = 52) |
Surgery, adjuvant chemotherapy, and radiotherapy | 60 mo | Multivariate analysis indicates high pretreatment NLR is correlated with poor DFS (p = 0.006) and OS (p = 0.04). |
| Asano et al. (25) | Japan | 2007–2013 | TNBC | 56 |
n = 177 NLR < 3 (n = 58) NLR > 3 (n = 119) |
NCT | 3.4 ys | Univariate analysis indicates low NLR is related to favorable prognosis in TNBC patients who achieved pCR (p = 0.044, hazard ratio = 0.06). |
| Rimando et al. (39) | USA | 2001–2013 | Non-metastatic BC | 58 |
n = 461 NLR ≤ 3.7 (n = 409) NLR > 3.7 (n = 52) |
Radiotherapy, chemotherapy | 61 mo | High pretreatment NLR indicates poor all-cause mortality, with a multivariable HR of 2.31 (95% CI: 1.10–4.86). |
| Iwase et al. (40) | Japan | 2005–2014 | TNBC | 50.9 |
n = 89 NRL = 3 |
Chemotherapy | NR | High NLR upon recurrence indicates shorter OS recurrence rates (p < 0.05). |
| Hernandez et al. (41) | Spain | 2003–2016 | Luminal A/B, ER/PR-positive, HER2-enriched, TNBC | 49.8 |
n = 150 NLR = 3.3 |
NCT, surgery | 24 mo | Low NLR indicates higher OS (p = 0.024). |
| Miyagawa et al. (42) | Japan | 2010–2017 | Locally Advanced or Metastatic BC | 63 |
n = 59 NLR < 3 (n = 24) NLR ≥ 3 (n = 35) |
Eribulin | NR | Low NLR indicates better PFS (p = 0.0032). |
| Ferroni et al. (43) | Italy | 2007–2017 | Luminal A/B, HER2-enriched, TNBC | 57 |
n = 475 NLR ≤ 2 (n = 245) NLR > 2 (n = 230) |
NCT, chemotherapy, endocrine therapy; trastuzumab regimens | 45.6 mo | High pretreatment NLR indicates worse DFS (HR = 2.28) and OS (HR = 3.39). |
| Qiu et al. (44) | China | 2006–2013 | Non-metastatic TNBC | 50 |
n = 406 NLR < 2.85 (n = 210) NLR ≥ 2.85 (n = 196) |
Surgery, NCT, chemotherapy | 54.3 mo | Low NLR indicates higher OS (p < 0.001) and DFS (p < 0.001). |
| Iimori et al. (30) | Japan | 2004–2013 | Luminal A/B, HER2-enriched, TNBC | 63 |
n = 34 NLR < 3 (n = 24) NLR ≥ 3 (n = 10) |
Endocrine therapy | 38.8 mo | Low NLR indicates a prolongation of PFS (p = 0.003) and OS (p = 0.013). |
| Mando et al. (45) | Argentina | 2011–2014 | Early stage BC | 56 |
n = 85 NRL = 2 |
Surgery | 38.6 mo | High NLR indicates lower DFS (p = 0.048). |
| Lee et al., (46) | Korea | 2008–2015 | TNBC | 51 |
n = 358 NLR ≤ 3.16 (n = 313) NLR > 3.16 (n = 45) |
NCT | NR | Low NLR indicates superior OS (p = 0.002) and DFS (p = 0.032). |
| Xuan et al. (19) | China | 2006–2008 | TNBC | 50 |
n = 286 NLR < 2.93 (n = 223) NLR ≥ 2.93(n = 63) |
Surgery | NR | Low NLR indicates longer DFS (p = 0). |
| Fujmoto et al. (47) | Japan | 2005–2016 | With high counts of lymphocytes | 30.7 |
n = 889 NLR < 2.72 (n = 582) NLR >2.72 (n = 307) |
Surgery, adjuvant chemotherapies, endocrine therapies | NR | Low NLR indicates better RFS (p = 0.036). |
| Imamura et al. (48) | Japan | 2011–2017 | HER2-enriched | 53 |
n = 53 NLR < 2.56 (n = 26) NLR ≥ 2.56 (n = 27) |
Trastuzumab emtansine | NR | Low NLR at baseline indicates better PFS (p = 0.0001) and OS (p = 0.0296). |
NLR, Neutrophil-to-lymphocyte ratio; ER, Estrogen receptor; PR, Progesterone receptor; HER2, Human epidermal growth factor receptor 2; Mo, Months; Ys, Years; DFS, Disease-free survival; OS, Overall survival; PFS, Progression-free survival; RFS, Relapse free survival; pCR, Pathological complete response; TNBC, Triple-negative breast cancer; NCT, Neoadjuvant chemotherapy; NR, Not recorded.