ArticleFrontiers in oncology2026
The prognostic value of lymphocyte-albumin-neutrophil ratio variability in patients with breast cancer undergoing radiotherapy.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Traditional static biomarkers often fail to capture the ongoing immune-nutritional trajectory of cancer patients. This study aimed to evaluate the prognostic relevance of dynamic variation in the Lymphocyte-Albumin-Neutrophil Ratio (LANR) in patients with operable breast cancer (BC), with exploratory analyses according to postoperative radiotherapy (RT) status. Methods: We retrospectively evaluated women with BC with operable invasive breast cancer. LANR variability was quantified using the coefficient of variation (CV) of the pre-operative and post-chemotherapy measurements to represent the magnitude of relative variability between the two time points. Patients were categorized into high and low LANR variability groups using a data-derived cutoff. Overall survival (OS) and progression-free survival (PFS) were assessed using Kaplan-Meier curves and multivariable Cox proportional hazards models, including an exploratory interaction analysis according to postoperative radiotherapy (RT) status. Results: Among 1800 nonmetastatic BC women included in total, 8.2% (148/1800) death and 12% (216/1800) recurrence occurred after a median follow-up of 93 months (interquartile range, 73-116 months). In the overall cohort, the proportion of deaths was higher in the high-variability group (9.43% vs. 6.49%, P = 0.031), and the Kaplan-Meier comparison showed poorer OS (P = 0.032). In the fully adjusted model, the overall association was not statistically significant (HR = 1.34, 95% CI: 0.94-1.89, P = 0.11). The LANR variability-by-RT interaction was statistically significant for OS (P for interaction = 0.01) but not for PFS (P for interaction = 0.685). In the RT subgroup, high LANR variability was associated with poorer OS (HR = 1.82, 95% CI: 1.10-3.03, P = 0.02), whereas no clear association was observed in the non-RT subgroup (HR = 1.02, 95% CI: 0.63-1.66, P = 0.92). Conclusions: LANR variability is an inexpensive and readily available dynamic immune-nutritional indicator. A high LANR variability may help identify patients who require closer follow-up and monitoring, especially for those receiving postoperative radiotherapy. Further prospective validation and comparative analyses with established inflammatory and nutritional markers are required before clinical implementation.
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