Photo Credit: Nemes Laszlo

Among patients with triple-negative breast cancer, the Naples prognostic score predicted survival outcomes more accurately than other markers.

The Naples prognostic score (NPS) predicted survival outcomes better than other nutrition and inflammatory indicators in patients with triple-negative breast cancer, according to a study published in the Journal of Inflammation Research.

“Researchers have developed the NPS score to provide an assessment of nutritional inflammation that integrates the impacts of nutrition, inflammation, immunology, and cancer. It includes factors such as neutrophil-to-lymphocyte ratio, lymphocytes, and albumin level among other biomarkers and has a strong prognostic predictive capacity,” wrote Weizhu Wu, MD, and colleagues.

The study included 223 women with triple-negative breast cancer who underwent surgery and postoperative adjuvant therapy — chemotherapy and radiation — at the Affiliated Lihuili Hospital between 2016 and 2020. Before surgery, patients had blood tests and biochemical analyses to check for various nutrition and inflammation markers.

Researchers retrospectively analyzed the ability of the NPS, along with the prognostic nutritional index (PNI) score and controlling nutritional status (CONUT) score, to predict overall and breast cancer-specific survival for patients.

According to the study, the NPS outperformed the other scores for predicting outcomes over 62 months. During follow-up, 39 patients experienced both metastasis and recurrence.

“A higher NPS is associated with a worse patient prognosis,” researchers wrote. “From a clinical standpoint, treatment strategies should be customized according to the patient’s NPS towards personalized treatments to extend survival in patients with triple-negative breast cancer.”

The study found that lymph node ratio, surgical method, postoperative chemotherapy, and NPS independently predicted overall survival. M stage, lymph node ratio, and NPS were independent predictors of breast cancer-specific survival.

The research team also developed and validated a visual tool for predicting outcomes based on NPS scores. Evaluations of the nomogram prediction model showed that its predicted overall and breast cancer-specific survival aligned well with actual overall and breast cancer-specific survival. A decision curve analysis suggested significant clinical utility.

“In addition, our prognostic model is more applicable and useful in clinical practice due to its reduced number of factors,” researchers wrote, “and the fact that the parameters are common laboratory indicators.”

The study had several limitations, including its limited sample size and single-center focus.