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Clinical relevance of lymph node ratio in breast cancer patients with one to three positive lymph nodes

Authors
 S I Kim  ;  S-H Cho  ;  J S Lee  ;  H-G Moon  ;  W C Noh  ;  H J Youn  ;  B K Ko  ;  B-W Park 
Citation
 British Journal of Cancer, Vol.109(5) : 1165-1171, 2013 
Journal Title
 British Journal of Cancer 
ISSN
 0007-0920 
Issue Date
2013
Abstract
BACKGROUND: To test the hypotheses that breast cancer patients with one to three positive lymph nodes (pN1) consist of heterogeneous prognostic subsets and that the ratio of positive nodes to total nodes dissected (lymph node ratio, LNR) might discriminate patients with a higher risk as candidates for post-mastectomy radiation therapy (PMRT). METHODS: Using information from 7741 node-positive patients, we first identified cutoff values of the LNR using the nonparametric bootstrap method. Focusing on 3477 patients with pN1 disease, we then evaluated the clinical relevance of the LNR categorised by the estimated cutoff values (categorised LNR, cLNR). RESULTS: Among 3477 patients with pN1 disease, 3059 and 418 patients were assigned into the low and intermediate cLNR groups, respectively, based on a cutoff value of 0.18. The prognostic factors associated with poor overall survival (OS) included younger age, T2 stage, negative oestrogen/progesterone receptors, high histologic grade, and intermediate cLNR. Post-mastectomy radiation therapy significantly increased OS in patients assigned to the intermediate cLNR (hazard ratio, 0.39; 95% confidence interval, 0.17-0.89; P=0.0248), whereas patients in the low cLNR group derived no additional survival benefit from PMRT. CONCLUSION: This study suggests that PMRT should be recommended for patients with pN1 disease and an intermediate cLNR.
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DOI
10.1038/bjc.2013.465
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
김승일(Kim, Seung Il)
박병우(Park, Byeong Woo) ORCID logo https://orcid.org/0000-0003-1353-2607
이준상(Lee, Jun Sang) ORCID logo https://orcid.org/0000-0002-4054-6900
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88959
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