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Meta-Analysis
. 2021 Jul 30;21(1):875.
doi: 10.1186/s12885-021-08582-1.

Prognostic significance of occult lymph node metastases in breast cancer: a meta-analysis

Guixin Wang #  1   2 , Shuhao Zhang #  3 , Meiling Wang  2 , Lin Liu  1 , Yaqian Liu  2 , Lianjun Tang  4 , He Bai  1 , Haidong Zhao  5
Affiliations
Meta-Analysis

Prognostic significance of occult lymph node metastases in breast cancer: a meta-analysis

Guixin Wang et al. BMC Cancer. .

Abstract

Background: Occult metastases in axillary lymph nodes have been reported to be associated with poor prognosis in patients with breast cancer. However, studies on the prognostic value of occult metastases have shown controversial results. This meta-analysis aimed to evaluate the prognostic significance of occult lymph node metastases in breast cancer.

Methods: Studies published until May, 2020, which retrospectively examined negative lymph nodes by stepsectioning and/or immunohistochemistry, were retrieved from MEDLINE, EMBASE, CNKI, and Cochrane Library databases. The pooled Relative Risk (RR) with 95% confidence interval (95% CI) for overall survival (OS) and disease-free survival (DFS) were calculated to examine the associations between occult metastases and prognosis.

Results: Patients with occult metastases in axillary lymph nodes had poorer five-year DFS (RR = 0.930; 95% CI = 0.907-0.954) and OS (RR = 0.972; 95% CI = 0.954-0.990). Furthermore, the DFS (RR = 0.887; 95% CI = 0.810-0.972) and OS (RR = 0.896; 95% CI = 0.856-0.939) of patients with occult metastases were significantly lower after a ten-year follow-up.

Conclusions: Occult metastases in the axillary lymph nodes are associated with poorer DFS andOS of patients with breast cancer. Occult metastases might serve as a predictive factor of survival outcomes in patients with breast cancer.

Keywords: Axillary lymph nodes; Breast cancer; Occult metastases; Recurrence; Survival.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of selection of studies and specific reasons for exclusion from the meta-analysis
Fig. 2
Fig. 2
Association between 5-y DFS and the present of occult ALN metastasis
Fig. 3
Fig. 3
Association between 5-y OS and the present of occult ALN metastasis
Fig. 4
Fig. 4
Association between 10-y DFS and the present of occult ALN metastasis
Fig. 5
Fig. 5
Association between 10-y OS and the present of occult ALN metastasis
Fig. 6
Fig. 6
Results of the sensitivity analysis. Results when each study is excluded are shown by the point estimate of the HR and 95% CI
Fig. 7
Fig. 7
Funnel plot analysis on the detection of publication bias in the meta-analysis of Prognostic Significance of Occult Lymph Node Metastases in breast cancer
See this image and copyright information in PMC

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