Lymph Node Ratio is More Predictive than Traditional Lymph Node Stratification in Lymph Node Positive Invasive Breast Cancer

Bai, Lian-Song; Chen, Chuang; Yang, Gong; Wen, Wei; Tu, Yi; Yao, Feng; Li, Juanjuan; Wang, Lijun; Sun, Shengrong

doi:10.7314/apjcp.2013.14.2.753

Cited by 8 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results showed a higher LNR obviously correlated with older age, larger tumor size, N stage, pathological type of IDC, Ki67 ≥14%, subtype, and pathological stage, which is consistent with previous studies (20,21). Moreover, in line with other studies, our results showed the LNR presented as a superior predictor in the survival outcome of pT1/2 breast cancer regardless of BCSS or OS (19,22,23). Breast cancer is considered a heterogeneous neoplasm, and different molecular subtypes are associated with distinct lymph node metastasis.…”

Section: Discussionsupporting

confidence: 92%

Potential prognostic value of the lymph node ratio and its correlation with circulating sex hormone concentration in pathological T1/2 breast cancer patients: a retrospective study

Zhu¹,

Qiu²,

Lin³

et al. 2022

Ann Transl Med

View full text Add to dashboard Cite

Background: The lymph node ratio (LNR) is an additional informative factor complementing anatomic TNM staging in breast cancer patients. The aim of this study was to evaluate the role of LNR in the cancerspecific and overall survival (OS) in a cohort of pT1/2 breast cancer patients and examine its correlation with circulating sex hormone concentrations in postmenopausal cases of the cohort from eastern China islands.Methods: Clinical and pathological characteristics, preoperational sex hormone and tumor markers concentrations, and breast cancer-specific survival (BCSS) and OS were analyzed retrospectively in 732 pathological T1/2 breast cancer patients. Results:The LNR was calculated, and the cut-off value was defined as 0.042 by receiver operative characteristic (ROC) curve according to the patient's mortalities. Patients with LNR ≥0.042 exhibited worse BCSS and OS than others (P<0.001) in pT1/2 breast cancer. Among patients with non-triple negative breast cancer (TNBC) and TNBC subtypes, the LNR ≥0.042 group also exhibited worse BCSS and OS than the LNR <0.042 group (P=0.003, 0.001, and P=0.032, 0.001, respectively). In univariate analysis, unfavorable BCSS and OS were both related with LNR ≥0.042 (P=0.001, <0.001). However multivariate analysis demonstrated TNBC subtypes were independent predictor for BCSS and OS [hazard ratio (HR) =1.449, 95% CI: 1.097-1.914, P=0.009; HR =1.365, 95% CI: 1.093-1.705, P=0.006, respectively]. Notably, Pearson or spearman correlation analysis revealed follicle-stimulating hormone (FSH) and, luteinizing hormone (LH) levels were significantly negatively associated with the LNR (P=0.007, 0.011, respectively) in postmenopausal cases, whereas CA153, CA125 and CEA were positively correlated with it (P<0.001, <0.001, 0.001, respectively) in all cases.Conclusions: Among pT1/2 breast cancer patients from eastern China islands, the LNR is a predictive prognosis factor; a higher LNR seems to correlate with a worse survival outcome both overall and in the subgroups. Strikingly, the current results reveal that serum FSH and LH level inversely associated with axillary node invasion in postmenopausal cases, whereas tumor markers directly related with it. The LNR is ^ ORCID: 0000-0003-4805-0800.

show abstract

Section: Discussionsupporting

confidence: 92%

Potential prognostic value of the lymph node ratio and its correlation with circulating sex hormone concentration in pathological T1/2 breast cancer patients: a retrospective study

Zhu¹,

Qiu²,

Lin³

et al. 2022

Ann Transl Med

View full text Add to dashboard Cite

show abstract

“…Several studies have reported that nodal involvement may be an independent prognostic parameter which is associated with a poor prognosis (19)(20)(21). However, there are limited published studies on this topic that evaluate the impact of node status on prognosis by molecular subtype in women with early breast cancer.…”

Section: Discussionmentioning

confidence: 99%

“…reported that a higher positive number of lymph nodes was associated with an inferior 5-year OS ( 13 ). On the face of it, nodal involvement and a higher number of positive nodes does increase the risk of survival ( 20 , 21 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of node status on breast cancer survival by subtype: a single-center retrospective cohort study

Lian¹,

Fu²,

Chen³

2020

Transl Cancer Res TCR

View full text Add to dashboard Cite

Background: Nodal involvement and molecular subtypes were used as independent prognostic indicators in women with breast cancer. However, they did not adequately address the effect of node status by subtype in outcomes.Methods: We performed a retrospective review of data from 2004 to 2011 from the Affiliated Union Hospital of Fujian Medical University with newly diagnosed stage I to III breast cancer to investigate the relationship between node status and 5-year disease-free survival (DFS) and breast cancer-specific survival (BCSS) by molecular subtype. The Cox proportional hazards model was used for multivariate analysis.Results: Median follow-up time was 6.4 years. Luminal HER2 and luminal B were the subtypes with a higher percentage of nodal involvement and high-volume nodal involvement (≥4 positive lymph node) than luminal A. The effect of node status on the prognosis varied with molecular subtype. There was no difference in 5-year DFS and BCSS between stage N1 or N2 and N0 groups in patients with luminal A disease. Nodal involvement in women with the luminal B, luminal HER2, and triple-negative subtypes showed significant difference for 5-year DFS and BCSS compared to the node negative group. Conclusions: Nodal involvement seems to be associated with worse survival in women with the luminal B, luminal HER2, and triple-negative subtypes, but not with the luminal A subtype.

show abstract

“…In this study, the utility of LNR was investigated as a factor to be considered in selecting SCNRT as a treatment for N1 breast cancer patients. Several studies have reported that nodal staging using LNR can predict the prognosis more effectively than conventional AJCC nodal staging [19,20,30]. In patients with N1 breast cancer with a relatively small number of metastatic lymph nodes, the prognosis can vary according to the total number of dissected lymph nodes, even in patients with the same number of metastatic lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of Lymph-Node Ratio in Determining Supraclavicular Lymph-Node Radiation Therapy in pN1 Breast Cancer Patients Who Received Breast-Conserving Treatment (KROG 14-18): A Multicenter Study

Kim

Park

Kim

et al. 2019

Cancers

View full text Add to dashboard Cite

This study evaluated the clinical significance of the lymph-node ratio (LNR) and its usefulness as an indicator of supraclavicular lymph-node radiation therapy (SCNRT) in pN1 breast cancer patients with disease-free survival (DFS) outcomes. We retrospectively analyzed the clinical data of patients with pN1 breast cancer who underwent partial mastectomy and taxane-based sequential adjuvant chemotherapy with postoperative radiation therapy in 12 hospitals (n = 1121). We compared their DFS according to LNR, with a cut-off value of 0.10. The median follow-up period was 66 months (range, 3–112). Treatment failed in 73 patients (6.5%) and there was no significant difference in DFS between the SCNRT group and non-SCNRT group. High LNR (>0.10) showed significantly worse DFS in both univariate and multivariate analyses (0.010 and 0.033, respectively). In a subgroup analysis, the effect of SCNRT on DFS differed significantly among patients with LNR > 0.10 (p = 0.013). High LNR can be used as an independent prognostic factor for pN1 breast cancer patients treated with partial mastectomy and postoperative radiotherapy. It may also be useful in deciding whether to perform SCNRT to improve DFS.

show abstract

Lymph Node Ratio is More Predictive than Traditional Lymph Node Stratification in Lymph Node Positive Invasive Breast Cancer

Cited by 8 publications

References 32 publications

Potential prognostic value of the lymph node ratio and its correlation with circulating sex hormone concentration in pathological T1/2 breast cancer patients: a retrospective study

Potential prognostic value of the lymph node ratio and its correlation with circulating sex hormone concentration in pathological T1/2 breast cancer patients: a retrospective study

Effect of node status on breast cancer survival by subtype: a single-center retrospective cohort study

Clinical Significance of Lymph-Node Ratio in Determining Supraclavicular Lymph-Node Radiation Therapy in pN1 Breast Cancer Patients Who Received Breast-Conserving Treatment (KROG 14-18): A Multicenter Study

Contact Info

Product

Resources

About