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. 2013 May 14:8:119.
doi: 10.1186/1748-717X-8-119.

Using the lymph nodal ratio to predict the risk of locoregional recurrence in lymph node-positive breast cancer patients treated with mastectomy without radiation therapy

San-Gang Wu  1 , Yong Chen, Jia-Yuan Sun, Feng-Yan Li, Qin Lin, Huan-Xin Lin, Zhen-Yu He
Affiliations

Using the lymph nodal ratio to predict the risk of locoregional recurrence in lymph node-positive breast cancer patients treated with mastectomy without radiation therapy

San-Gang Wu et al. Radiat Oncol. .

Abstract

Background: To evaluate the prognostic value of axillary lymph node ratio (LNR) as compared to the number of involved nodes (pN stage) in patients with axillary lymph node-positive breast cancer treated with mastectomy without radiation.

Methods: We performed a retrospective analysis of the clinical data of patients with stage II-III node-positive breast cancer (N=1068) between 1998 and 2007. Locoregional recurrence-free survival (LRFS) and overall survival (OS) were compared based on the LNR and pN staging.

Results: A total of 780 cases were classified as pN1, 183 as pN2, and 105 as pN3. With respect to LNR, 690 cases had a LNR from 0.01-0.20, 269 cases a LNR from 0.21-0.65, and 109 cases a LNR > 0.65. The median follow-up time was 62 months. Univariate analysis showed that both LNR and pN stage were prognostic factors of LRFS and OS (p<0.05). Multivariate analysis indicated that LNR was an independent prognostic factor of LRFS and OS (p<0.05). pN stage had no significant effect on LRFS or OS (p>0.05). In subgroup analysis, the LNR identified groups of patients with different survival rates based on pN stage.

Conclusions: LNR is superior to pN staging as a prognostic factor in lymph node-positive breast cancer after mastectomy, and should be used as one of the indications for adjuvant radiation therapy.

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Figures

Figure 1
Figure 1
Kaplan-Meier cumulative survival curves for different lymph node ratio (LNR) and pN stage. (A, B) Locoregional recurrence-free survival and (C, D) overall survival for (A, C) pN and (B, D) LNR.
Figure 2
Figure 2
Kaplan-Meier cumulative survival curves for different lymph node ratio according to different pN stage. (A, C, E) Locoregional recurrence-free survival (LRFS) and (B, D, F) overall survival for (A, B) pN1, and (C, D) pN2, and (E, F) pN3.
See this image and copyright information in PMC

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