Abstract
Background
Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) are widely used to assess patient’s outcome in many types of neoplasms including breast cancer. The aim of this study was to select the best parameter with a high prognostic value by defining the optimal cutoff value for each parameter in patients undergoing mastectomy.
Patients and Methods
This is a retrospective monocentric study enrolling 59 patients. The receiver operating characteristic (ROC) curve was used for the obtention of the optimal cutoff values of NLR, PLR, MLR, SII, and SIRI. The Kaplan–Meier curve and log-rank test were used to assess recurrence-free survival (RFS), distant metastasis-free survival (DMFS), and overall survival (OS).
Results
Among the five parameters, we obtained the optimal cutoff values for NLR, MLR, SII, and NLR but not for PLR (AUC ≤0.5). To assess the RFS, the optimal cutoff values for NLR, MLR, SII, and SIRI were defined as 2.11, 0.16, 472, and 0.6888, respectively. High MLR (p= 0.0165), SII (p= 0.0368), and SIRI (p= 0.012) were associated to shorter RFS. For DMFS, the optimal cutoff values for NLR, MLR, SII, and SIRI were 1.60, 0.28, 472, and 0.6888, respectively. Interestingly, the Kaplan–Meier curve showed that patients with high MLR (p< 0.0001), SII (p= 0.0345), and SIRI (p= 0.0255) exhibited shorter DMFS.
Conclusions
The MLR, SII, and SIRI indices would be the best indicators. They could constitute a promising predictive tool in the detection of locoregional and distant metastasis.