Grade-lymph node ratio predicts the survival of breast cancer in different molecular types

Liu, Chaoqun; Li, Huiyao; Zhuo, Ran; Wang, Lijun; Li, He; Ruan, Qiqi; Luan, Xiaoyi; Xiu-juan, MO; Sun, Yi

doi:10.1097/md.0000000000016436

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…The LNR has been reported to be a significant prognostic factor in the survival of BC patients in many recent studies [13][14][15][16], and some studies have also reported that the LNR is superior to traditional pN stage in predicting BC prognosis. Currently, NAC is broadly used in the systematic treatment of BC.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Lymph Node Ratio in Breast Cancer Patients with Adequate Pathologic Evidence After Neoadjuvant Chemotherapy

Liao

Wang

et al. 2020

Med Sci Monit

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Departmental sources Background:The prognostic role of axillary lymph node ratio (LNR) after neoadjuvant chemotherapy (NAC) in breast cancer has not been illuminated. This study was designed to investigate the prognostic role of LNR in breast cancer compared with traditional ypN stage. Material/Methods:A total of 306 breast cancer patients diagnosed with positive axillary lymph nodes from January 2007 to December 2014 were eligible for this retrospective analysis. All enrolled patients were treated with a median of 4 cycles of NAC followed by mastectomy and level I, II, and III axillary lymph node dissection (ALND). Results:The median duration of follow-up was 78 months (range, 7-147 months). Univariate analysis indicated that both the LNR category (P<0.001) and ypN stage (P<0.001) were significant associated with event-free survival (EFS) and overall survival (OS). However, multivariate analysis indicated that the LNR category was independently associated with EFS (P<0.001) and OS (P<0.001), while the ypN stage showed no statistical effect on EFS (P=0.391) or OS (P=0.081). On additional analyses stratified by molecular subtypes, we found that the prognosis of triple negative breast cancer could be better discriminated when the cutoff value of LNR was set at 0.15. Conclusions:LNR showed a superior predictive value in evaluating prognosis of breast cancer patients after NAC. In addition, the LNR cutoff point 0.15 can accurately discriminate survival outcomes for different triple negative breast cancer subtypes.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Lymph Node Ratio in Breast Cancer Patients with Adequate Pathologic Evidence After Neoadjuvant Chemotherapy

Liao

Wang

et al. 2020

Med Sci Monit

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“…Pharmacological inhibition of ACC1 activity abrogated the dissemination of 4T1 murine breast cancer cells to the lung (29). Indeed, accumulating evidence suggests that extensive lymph node metastasis is associated with poor prognosis, as well as short overall and disease-free survival of patients with breast cancer (30,31). In this study, the role of HLCS in supporting cell invasion was demonstrated in the MCF-7 cell line in which suppression of HLCS expression resulted in 40-50% reduction of cell invasion through extracellular matrix.…”

Section: Discussionmentioning

confidence: 99%

Overexpression of Holocarboxylase Synthetase Predicts Lymph Node Metastasis and Unfavorable Prognosis in Breast Cancer

et al. 2020

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Background/Aim: Holocarboxylase synthetase (HLCS) catalyzes the specific attachment of biotin onto biotin-dependent carboxylases (BDCs) which play important roles in intermediary metabolism. Previous studies show that BDCs are overexpressed in many cancer types. However, expression of HLCS in cancerous tissues has not been reported. Materials and Methods: Immunohistochemistry was used to investigate HLCS expression in breast tissue obtained from 65 Thai patients, and the correlation between its expression and key clinical-pathological parameters was assessed. The role of HLCS in supporting invasion was investigated in HLCS-knockdown MCF-7 cells. Results: Overexpression of HLCS was significantly associated with metastasis of breast cancer cells to other lymph nodes but not the sentinel and axillary lymph nodes -a finding supported in cellular invasion assays using HLCS knockdown cells. Furthermore, overexpression of HLCS reduced survival time of patients with breast cancer. Conclusion: HLCS appears to be a prognostic marker for patients with breast cancer.

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“…Increased lymph node ratio has been repeatedly shown to predict long-term survival in various cancers. 6–8,12 Selecting patients for adjuvant therapy based on lymph node ratio, or evaluating impacts of lymph node ratio on adjuvant therapy effectiveness, has been studied for others cancers like gastric, 27 pancreatic, 28 and esophageal. 29 As for colon cancer, Moug et al considered the value in lymph node ratio for staging colon cancer, and its implications on determining which patients would benefit from adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…5 A number of observational studies have demonstrated that lymph node ratio to be a prognostic factor for other cancers such as head-and-neck, 6 esophageal, 7 and breast. 8 These findings are also reflected in numerous colorectal cancer observational studies examining lymph node ratio and long-term survival. 9–11 However, there is no consensus regarding the extent to which different lymph node ratio cut-off values predict long-term survival and how to use this value in conjunction with overall lymph node harvest.…”

Section: Introductionmentioning

confidence: 86%

Lymph Node Ratio as a Predictor of Survival for Colon Cancer: A Systematic Review and Meta-Analysis

Ichhpuniani,

McKechnie,

Lee

et al. 2023

The American Surgeon™

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Background Lymph node ratio is the number of lymph nodes with evidence of metastases on pathological review compared to the total number of lymph nodes harvested during oncologic resection. Lymph node ratio is a proven predictor of long-term survival. These data have not been meta-analyzed to determine the prognosis associated with different lymph node ratio cut-offs in colon cancer. Methods Medline, Embase, and CENTRAL were systematically searched. Articles were included if they compared 5-year overall survival (OS) or disease-free survival (DFS) between different lymph node ratios for patients undergoing oncologic resection for stages I-III colon cancer. Pairwise meta-analyses using inverse variance random effects were performed. Results From 2587 citations, nine studies with 97,631 patients (female: 51.9%, median age: 61.65 years) were included. A lymph node ratio above .1 resulted in a 49% decrease in the odds of 5-year OS (2 studies; OR: 0.51, 95% CI: 0.49-.53, P < .00001). A lymph node ratio above .25 resulted in a 56% decrease in the odds of 5-year OS (3 studies; OR: 0.44, 95% CI: 0.43-.45, P < .00001). A lymph node ratio above .5 resulted in a 65% decrease in the odds of 5-year OS (3 studies; OR: 0.35, 95% CI: 0.33-.37, P < .00001). Conclusions Lymph node ratios from .1 to .5 are effective predictors of 5-year OS for colon cancer. There appears to be an inverse dose-response relationship between lymph node ratio and 5-year OS. Further study is required to determine whether there is an optimal lymph node ratio cut-off for prognostication and whether it can inform which patients may benefit from more aggressive adjuvant therapy and follow-up protocols.

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Grade-lymph node ratio predicts the survival of breast cancer in different molecular types

Abstract: Supplemental Digital Content is available in the text

Cited by 6 publications

References 26 publications

Prognostic Value of Lymph Node Ratio in Breast Cancer Patients with Adequate Pathologic Evidence After Neoadjuvant Chemotherapy

Prognostic Value of Lymph Node Ratio in Breast Cancer Patients with Adequate Pathologic Evidence After Neoadjuvant Chemotherapy

Overexpression of Holocarboxylase Synthetase Predicts Lymph Node Metastasis and Unfavorable Prognosis in Breast Cancer

Lymph Node Ratio as a Predictor of Survival for Colon Cancer: A Systematic Review and Meta-Analysis

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