Preoperative lymphocyte-albumin-monocyte index as an inflammation- and nutrition-based predictor of overall survival in triple-negative breast cancer: A retrospective cohort study.

Serum albumin (ALB) and the lymphocyte-to-monocyte ratio (LMR) are established inflammation- and nutrition-related biomarkers associated with tumor progression. Their combined prognostic value in triple-negative breast cancer (TNBC) has not been fully defined. Therefore, the present study aimed to develop and demonstrate a lymphocyte-albumin-monocyte index (LANI) that integrates ALB and LMR for prognostic assessment in TNBC. A retrospective cohort of 166 surgically treated patients with TNBC was analyzed and divided into training (n=116) and validation (n=50) cohorts. Receiver operating characteristic analysis yielded optimal thresholds of 39.35 g/l for ALB and 2.526 for LMR, which were rounded to clinical cutoffs of 40 g/l and 2.97. Patients were categorized into three LANI groups, namely LANI=0 (ALB <40 g/l and LMR <2.97), LANI=1 (either indicator above the cutoff) and LANI=2 (both indicators above the cutoff). Multivariate Cox analysis demonstrated that tumor stage, histologic grade and LANI were independent predictors of overall survival, with a LANI value of 2 indicating markedly reduced mortality risk (hazard ratio=0.03; 95% CI: 0.002-0.46; P=0.012). A nomogram incorporating these factors showed strong discrimination, good calibration and a meaningful clinical net benefit across both cohorts. Overall, the LANI provides a simple, reproducible and cost-effective biomarker that enhances prognostic stratification and supports individualized management in TNBC.