Abstract:
Objectives To investigate if lymph node ratio(LNR) is better than positive lymph nodes(PLN) in evaluating recurrence hazard and overall survival time of breast carcinoma patients.
Methods The medical records of 1, 089 primary invasive breast cancer patients were retrospectively analyzed.All the patients have 10 or more lymph nodes identified in axillary dissection and presented with one or more PLN.which were confirmed by postoperative pathological examination.
Results In univariate analyses, pT-stage, grade, ER / PR /HER-2 status.PLN, LNR.total lymph nodes dissected, extranodal soft tissue invasion, and adjuvant treatment(chemotherapy, radiotherapy, and endocrine therapy) were associated significantly with relapse-free survival(RFS) and overall survival(OS)(P < 0.0?).In multivariate analyses, when PLN or LNR were entered into the Cox hazard ratio model as covariate, both PLN and LNR were the dependent prognostic factors of RFS(P < 0.001) and OS(P < 0.001).When PLN and LNR were entered into the Cox hazard ratio model as covariates at the same time.LNR remained as the dependent prognostic factor of RFS(P < 0.001) and OS(P = 0.001), but PLN lost significance(RFS: P = 0.944, OS: P=0.315).
Conclusion Compared with the number of involved lymph nodes.LNR can predict recurrence hazard and OS more efficiently.It provides a more powerful reference for breast cancer risk classification, allowing clinicians to make decisions on adjuvant therapy.
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