Hala A El-Lathy, Ahlam A Dohal and Ahmed E Abbas
Purpose: To evaluate baseline PET/CT SUVmax value and Neutrophil/lymphocyte ratio (NLR), as prognostic indicators of progression free survival (PFS) and overall survival (OS) in surgically treated oligmetastatic breast cancer (OMBC) patients.
Materials and Methods: The pretreatment 18FDG-PET-CT SUVmax and NLR in surgically treated OMBC patients were compared with clinicopathological parameters. The prognostic value of pretreatment SUVmax and NLR for PFS and OS were assessed using Log rank and Cox regression.
Results: Overall, 87 OMBC were included, mastectomy and axillary clearance was performed in 72 patients (83%) who responded to preoperative systemic. The receiver operator curve (ROC) demonstrated that SUVmax of 4.4 and 6.5 to be the cut off value for predicting PFS in patients with oligometastasis to bones and visceral organs respectively. Additionally, baseline NLR cut off value of 2.7 predicted PFS in all studied patients. In surgically treated 46 OMBC patients (64%) to bones SUVmax of >4.4 had a significantly shorter OS [Hazard ratio (HR 2.9)] <4.4 (P<0.01), whereas patients with SUVmax of ≤4.4 had significantly longer PFS compared with those with SUVmax >4.4 (P=0.02). Similarly, 26 OMBC patients (36%) to visceral organs with SUVmax ≤6.5 had significant improvement in OS compared to those with SUVmax >6.5 (HR 2.3)]. Moreover, patients with NLR ≥2.7 showed significantly lower PFS (HR, 2., P<0.001) and overall survival rate (HR,1.9, P=0.02) than patients with NLR<2.7. Cox regression multivariate for OS revealed that higher baseline SUV max and NLR along with visceral metastasis were independently correlated with poor prognosis, with HR 3.04, 8.83 and 9.21 respectively. Conclusion: The pretreatment PET-CT SUVmax and NLR showed
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