Prognostic value of metastatic lymph node ratio in locally advanced breast cancer

Abstract

Aim: In this study we evaluated the prognostic value of the lymph node ratio. (LNR: defined as the number of involved nodes divided by the number of the nodes examined). Patients and Methods: In this retrospective study, patients underwent axillary dissection due to breast cancer were examined. We evaluated 348 women underwent axillary dissection for nonmetastatic breast cancer in 9 Eylül University Hospital between 2006 and 2016. LNR were divided into three groups as low, intermediate and high risk (low, ≤0.20; intermediate, 0.21-0.65; high, > 0.65). Overall survival of the patients was estimated by the Kaplan Meier method for LNR. Overall relative mortality risks associated with LNR and pN were calculated by Cox regression. Results: The mean survival was 95.1 months LNR high-risk group, while it was 100 months in N3 group. Even though it was not statistically significant, a lower survival rate of less than 5 months was observed in the LNR high group (P <0.74). High LNR associated with poor dissease specific survival rates with the mean 76.73 months of follow up. In the multivariate analysis, high LNR was an independent poor prognostic factor in breast cancer (LNR>0.65 HR 3.08; p=0.002). Conclusion: LNR is highly significant in breast cancer and it provides more valuable information rather than TNM in terms of prognosis. Therefore, we think that, LNR can be used as a beneficial tool in breast cancer staging.

Keywords

• breast cancer
• lymph node ratio
• survival

Lokal ileri meme kanserinde metastatik lenf nodu oranının prognostik değeri

Abstract

Öz Amaç: Bu çalışmada, lenf nodu oranının prognostik önemini değerlendirdik (LNR: metastatik lenf nodlarının toplam disseke edilen lenf nodlarına oranı). Gereç ve Yöntemler: Bu retrospektif çalışmada meme kanseri nedeniyle koltuk altı diseksiyonu yapılan hastalar incelendi. 2006-2016 yılları arasında 9 Eylül Üniversitesi Hastanesi'nde metastatik olmayan meme kanseri nedeniyle koltuk altı diseksiyonu yapılan 348 kadını değerlendirdik. LNR düşük, orta ve yüksek riskli (düşük, ≤0.20; orta, 0.21-0.65; yüksek> 0.65) olarak üç gruba ayrıldı. Hastaların genel sağkalımı, LNR için Kaplan Meier yöntemi ile tahmin edildi. LNR ve pN ile ilişkili genel bağıl ölüm riskleri Cox regresyonu ile hesaplandı. Bulgular: Ortalama talip süresi 76.73 ay olarak bulundu. Ortalama sağkalım LNR yüksek riskli grupta 95.1 ay iken, N3 grubunda 100 aydı. İstatistiksel olarak anlamlı olmamakla birlikte, LNR yüksek grupta 5 aydan daha düşük sağkalım oranı gözlendi (P <0.74). Çok değişkenli analizde, yüksek LNR, meme kanserinde bağımsız bir kötü prognostik faktördü (LNR> 0.65 HR 3.08; p = 0.002). Sonuç: LNR meme kanserinde oldukça önemlidir ve prognoz açısından TNM'den çok daha değerli bilgiler sağlar. Bu nedenle LNR'nin meme kanseri evrelemesinde faydalı bir araç olarak kullanılabileceğini düşünüyoruz.

Keywords

• meme kanseri
• lenf nodu oranı
• survi

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