Metastatic Axillary Lymph Node Ratio (LNR) is Prognostically Superior to pN Staging in Patients with Breast Cancer -- Results for 804 Chinese Patients from a Single Institution

Xiao, Xiang; Tang, Hai; Xie, Xin; Li, Lai Sheng; Kong, Yunhong; Wu, Min; Yang, Lu; Gao, Jie; Wei, Wei Dong; Xie, Xiaoming

doi:10.7314/apjcp.2013.14.9.5219

Cited by 9 publications

(10 citation statements)

References 27 publications

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“…Recently, ratio of PLNs to RLNs (LNR) and log of odds between PLNs and the number of negative lymph node (LODDS) have emerged as alternative predictive factors for outcomes in breast [6, 7], gastric [8], pancreatic [9] and colorectal cancer [10, 11]. LNR is defined as the ratio of PLNs to RLNs.…”

Section: Introductionmentioning

confidence: 99%

“…LNR is defined as the ratio of PLNs to RLNs. This parameter showed superiority to the lymph node status-based assessment system of N stage in several cancers, such as breast [6, 12], gastric [8], and colon cancer [13, 14]. LNR was also studied in ovarian cancer and found to be superior to both PLN and RLN number in predicting survival [15, 16].…”

Section: Introductionmentioning

confidence: 99%

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A novel nomogram based on LODDS to predict the prognosis of epithelial ovarian cancer

Cheng

Tang³

et al. 2016

Oncotarget

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BACKGROUNDTo develop and validate a nomogram based on log of odds between the number of positive lymph node and the number of negative lymph node (LODDS) in predicting the overall survival (OS) and cancer specific survival (CSS) for epithelial ovarian cancer (EOC) patients.MATERIALS AND METHODSA total of 10,692 post-operative EOC patients diagnosed between 2004 and 2013 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training (n = 7,021) and validation (n = 3,671) cohorts. Multiple clinical pathological parameters were assessed and compared with outcomes. Parameters significantly correlating with outcomes were used to build a nomogram. Bootstrap validation was subsequently used to assess the predictive value of the model.RESULTSIn the training set, age at diagnosis, race, marital status, tumor location, stage, grade and LODDS were correlated significantly with outcome in both the univariate and multivariate analyses and were used to develop a nomogram. The nomogram demonstrated good accuracy in predicting OS and CSS, with a bootstrap-corrected concordance index of 0.757 (95% CI, 0.746-0.768) for OS and 0.770 (95% CI, 0.759-0.782) for CSS. Notably, in this population our model performed favorably compared to the currently utilized Federation of Gynecology and Obstetrics (FIGO) model, with concordance indices of 0.699 (95% CI, 0.688-0.710, P < 0.05) and 0.719 (95% CI, 0.709- 0.730, P < 0.05) for OS and CSS, respectively. Using our nomogram in the validation cohort, the C-indices were 0.757 (95% CI, 0.741-0.773, P < 0.05, compared to FIGO) for OS and 0.762 (95% CI, 0.746-0.779, P < 0.05, compared to FIGO) for CSS.CONCLUSIONSLODDS works as an independent prognostic factor for predicting survival in patients with EOC regardless of the tumor stage. By incorporating LODDS, our nomogram may be superior to the currently utilized FIGO staging system in predicting OS and CSS among post-operative EOC patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A novel nomogram based on LODDS to predict the prognosis of epithelial ovarian cancer

Cheng

Tang³

et al. 2016

Oncotarget

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“…[5,12] The current AJCC staging system for breast cancer relies on the absolute number of malignant lymph nodes, but the heterogeneity results from the lymph node examinations may cause variations between centers because of the differences in procedures of lymph node clearance, physical and specimen examination findings. [9] Compared with the lymph node number, many studies have indicated that mLNR is a more accurate prognostic factor of survival in breast cancer. [13,14] The mLNR system was developed and evaluated largely as a way to mitigate low lymph node counts [15,16] and provides a standardized value for comparison of prognosis across patients, regardless of whether very few or very many lymph nodes were retrieved.…”

Section: Discussionmentioning

confidence: 99%

“…[5–7] Till now, no consensus has been reached on the robust and reproducible classification of metastatic lymph node ratio (mLNR), [8] and limited studies revealing the prognostic value of mLNR in breast cancer patients with different molecular subtypes have been reported. [9,10]…”

Section: Introductionmentioning

confidence: 99%

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

Liu

Zhuo

et al. 2019

Medicine

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“…[ 24 25 ] LNR has also been discussed as a prognostic factor in other cancers such as gastric, breast, and colon cancers. [ 26 27 28 ]…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of lymph node ratio in survival of head-and-neck squamous cell carcinoma

et al. 2018

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Background:Head-and-neck squamous cell carcinoma (HNSCC) is the sixth most prevalent type of cancers in the world. Due to its relatively high rate of recurrence, the prognosis of patients is poor and the survival rate is low; therefore, identifying the prognostic factors is considered necessary for better treatment.Materials and Methods:This historical cohort study was conducted on 201 patients diagnosed with aerodigestive SCC who underwent surgery and lymph node dissection. We determined the prognostic value of lymph node ratio (LNR) on overall survival (OS), disease-free survival (DFS), and locoregional failure-free survival (LFFS). We noticed an association between LNR and survival by Kaplan–Meier analysis. Hazard ratio (HR) of LNR was determined by Cox's regression model.Results:Two hundred and one patients entered this study after their medical histories were evaluated. The mean of lymph node count and LNR was 14.30 (±9.50) and 0.12 (±0.23), respectively. Eighty patients (39.80%) experienced recurrence of SCC. Five-year OS, DFS, and LFFS were 32%, 21%, and 64%, respectively. The median of OS was 40.70 months and 30.11 months in patients with LNR of ≤0.06 and >0.06, respectively (P < 0.01). The LNR >0.06 was found to be a significant prognostic factor for lower OS of patients with HNSCC (HR = 2.11 [1.10, 4.40]; P = 0.04). DFS was not significantly different among patients with LNR ≤0.06 and patients with LNR >0.06 (P = 0.9). However, LFFS was slightly different among two groups (HR = 2.04 [0.90–4.80]; P < 0.1).Conclusion:We recommend more intensive adjuvant therapies such as chemotherapy with radiotherapy and short interval follow-up for patients with LNR >0.06. Further investigations with larger sample sizes are recommended.

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Metastatic Axillary Lymph Node Ratio (LNR) is Prognostically Superior to pN Staging in Patients with Breast Cancer -- Results for 804 Chinese Patients from a Single Institution

Cited by 9 publications

References 27 publications

A novel nomogram based on LODDS to predict the prognosis of epithelial ovarian cancer

A novel nomogram based on LODDS to predict the prognosis of epithelial ovarian cancer

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

The prognostic value of lymph node ratio in survival of head-and-neck squamous cell carcinoma

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