Savioli, F., Morrow, E. S., Dolan, R. D. , Romics, L., Lannigan, A., Edwards, J. and McMillan, D. C. (2022) Prognostic role of preoperative circulating systemic inflammatory response markers in primary breast cancer: meta-analysis. British Journal of Surgery, 109(12), pp. 1206-1215. (doi: 10.1093/bjs/znac319) (PMID:36130112)
Full text not currently available from Enlighten.
Abstract
Background: Circulating markers of the systemic inflammatory response are prognostic in several cancers, but their role in operable breast cancer is unclear. A systematic review and meta-analysis of the literature was carried out. Methods: A search of electronic databases up to August 2020 identified studies that examined the prognostic value of preoperative circulating markers of the systemic inflammatory response in primary operable breast cancer. A meta-analysis was carried out for each marker with more than three studies, reporting a HR and 95 per cent confidence interval for disease-free survival (DFS), breast cancer-specific survival (BCSS) or overall survival (OS). Results: In total, 57 studies were reviewed and 42 were suitable for meta-analysis. Higher neutrophil-to-lymphocyte ratio (NLR) was associated with worse overall survival (OS) (pooled HR 1.75, 95 per cent c.i. 1.52 to 2.00; P < 0.001), disease-free survival (DFS) (HR 1.67, 1.50 to 1.87; P < 0.001), and breast cancer-specific survival (BCSS) (HR 1.89, 1.35 to 2.63; P < 0.001). This effect was also seen with an arithmetically-derived NLR (dNLR). Higher platelet-to-lymphocyte ratio (PLR) was associated with worse OS (HR 1.29, 1.10 to 1.50; P = 0.001) and DFS (HR 1.58, 1.33 to 1.88; P < 0.001). Higher lymphocyte-to-monocyte ratio (LMR) was associated with improved DFS (HR 0.65, 0.51 to 0.82; P < 0.001), and higher C-reactive protein (CRP) level was associated with worse BCSS (HR 1.22, 1.07 to 1.39; P = 0.002) and OS (HR 1.24, 1.14 to 1.35; P = 0.002). Conclusion: Current evidence suggests a role for preoperative NLR, dNLR, LMR, PLR, and CRP as prognostic markers in primary operable breast cancer. Further work should define their role in clinical practice, particularly reproducible thresholds and molecular subtypes for which these may be of most value.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Edwards, Professor Joanne and Romics, Mr Laszlo and Morrow, Dr Elizabeth and Savioli, Ms Francesca and Dolan, Dr Ross and McMillan, Professor Donald and Lannigan, Mrs Alison |
| Authors: | Savioli, F., Morrow, E. S., Dolan, R. D., Romics, L., Lannigan, A., Edwards, J., and McMillan, D. C. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | British Journal of Surgery |
| Publisher: | Oxford University Press |
| ISSN: | 0007-1323 |
| ISSN (Online): | 1365-2168 |
| Published Online: | 20 September 2022 |
University Staff: Request a correction | Enlighten Editors: Update this record
Deposit and Record Details
Deposit and Record Details