Value of the pretreatment albumin to globulin ratio in predicting long-term mortality in breast cancer patients.

BACKGROUND: Prior studies have demonstrated the prognostic value of pretreatment serum albumin in different types of cancer. The aim of this study was to assess the predictive value of the albumin to globulin ratio (AGR) on survival in breast cancer patients. METHODS: This retrospective study used an unselected cohort of 354 breast cancer patients who had documented total protein and albumin levels prior to chemotherapy. Survival status was obtained from our cancer registry. Survival analysis, stratified by AGR tertiles, was used to evaluate the prognostic value of AGR. RESULTS: Patients in the highest AGR tertiles (AGR > 1.45) had a lower 5-year mortality rate compared with those in the middle (AGR 1.21 to 1.45) and the lowest (AGR < 1.21) tertiles (6% vs. 18% and 32%, P < .001). After adjusting for confounding variables, AGR remained a significant predictor of mortality (P < .002). Moreover, after excluding the patients with albumin levels less than 3.6, the AGR remained a significant predictor of survival (P .0018). CONCLUSIONS: Pretreatment AGR is an independent, significant predictor of long-term mortality in breast cancer patients, even in patients with normal albumin levels.

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

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.