Pretreatment neutrophil/lymphocyte ratio is superior to platelet/lymphocyte ratio as a predictor of long-term mortality in breast cancer patients

Basem Azab, Neeraj Shah, Jared Radbel, Pamela Tan, Vijaya Bhatt, Steven Vonfrolio, Ayman Habeshy, Antonio Picon, Scott Bloom

Research output: Contribution to journalArticle

144 Scopus citations


The aim of our study was to assess the predictive value of platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) in terms of survival in breast cancer patients. This is an observational study of 437 breast cancer patients treated between January 2004 and December 2006. Survival status was obtained from our cancer registry and Social Security Death Index. Survival analysis, stratified by NLR and PLR quartiles, was used to evaluate their prognostic values. Patients in the highest 4th PLR and NLR quartiles had higher 5-year mortality rate (30.4 and 40.3 %) compared to those in the lower three PLR and NLR quartiles (12.1 and 8.2 %), p < 0.0001. Multivariate hazard ratios of 4th PLR and NLR quartiles compared to first PLR and NLR quartiles were 3.68 (1.74-7.77, p = 0.001) and 3.67 (1.52-8.86, p = 0.004). Higher PLR only showed a trend of higher mortality in patients with normal lymphocyte count, whereas NLR continued to be statistically significant predictor of 5-year mortality in all lymphocyte count subsets. Pretreatment NLR is an independent predictor of long-term mortality in breast cancer patients, whereas pretreatment PLR was not superior to absolute lymphocyte count alone in predicting long-term mortality.

Original languageEnglish (US)
Article number432
JournalMedical Oncology
Issue number1
StatePublished - Mar 1 2013



  • Breast cancer
  • Mortality
  • NLR
  • Neutrophil-lymphocyte ratio
  • PLR
  • Platelet-lymphocyte ratio

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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