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

Radiation Oncology

Zhen-Yu He²  Huan-Xin Lin²  Qin Lin¹  Feng-Yan Li²  Jia-Yuan Sun²  Yong Chen²  San-Gang Wu¹ 

[1] Xiamen Cancer Center, Department of Radiation Oncology, the First Affiliated Hospital of Xiamen University, Xiamen, 361003, People’s Republic of China;Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou 510060, People’s Republic of China

关键词: Radiotherapy;    Recurrences;    Mastectomy;    Lymph node ratio;    Breast cancer;   

Others  :  1153954
DOI  :  10.1186/1748-717X-8-119

 received in 2012-11-19, accepted in 2013-05-08,  发布年份 2013

【 摘 要 】

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.

【 授权许可】

   
2013 Wu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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