+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The lymph node ratio as an independent prognostic factor for non-metastatic node-positive breast cancer recurrence and mortality



The lymph node ratio as an independent prognostic factor for non-metastatic node-positive breast cancer recurrence and mortality



Journal of BUON 20(3): 737-745



To examine the prognostic value of lymph node ratio (LNR) in pathological nodal (pN) stage breast cancer patients. Also, to analyse additional clinical and pathologic prognostic factors and the impact of LNR among molecular subtypes. Among a total of 3088 patients, 1004 women with non-metastatic lymph node-positive breast cancer were analysed. The patients were classified into low (≤0.20), intermediate (0.20 to 0.65) and high-risk (>0.65) LNR groups. Univariate and multivariate Cox proportional hazards regression model for disease-free survival (DFS), and overall survival (OS) were performed to evaluate the prognostic value of LNR. The median LNR was 0.17 (range 0.02-1.00). Of the patients, 55.7% were in low, 32.1% in intermediate, and 12.3% in high risk group. When compared with low risk group, high risk group had more often large tumor size and high grade tumor with lymphovascular invasion. The median follow-up period was 46.8 months. The 5-year breast cancer-specific OS and DFS rates for patients with low, intermediate, and high were 88%-67%, 65%-48% and 53%-24%, respectively (both plog-rank<0.0001). On multivariate analysis, pN stage and LNR were both independent predictors of survival, however, an overlapping between N1 (250 months, 95% confidence interval [CI] 88.15-413.21) and N2 (176 months, 95% CI 129.51-222.93) curves in pN staging was determined. We also observed clear prognostic separation for triple negative breast cancer with LNR survival over pN staging. The LNR predicts survival more accurately than pN staging in node-positive breast cancer patients. The use of LNR may standardize the staging and guide decisions for adjuvant treatments.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 059084542

Download citation: RISBibTeXText

PMID: 26214625


Related references

The lymph node ratio as an independent prognostic factor for node-positive triple-negative breast cancer. Oncotarget 8(27): 44870-44880, 2017

Prognostic value of metastatic axillary lymph node ratio in node-positive breast cancer treated by breast conserving surgery. Zhonghua Zhong Liu Za Zhi 37(1): 41-46, 2015

The lymph node ratio as prognostic factor in node-positive breast cancer. RadioTherapy and Oncology 70(3): 225-230, 2004

The ratio of metastatic/resected lymph nodes is an independent prognostic factor in patients with node-positive pancreatic head cancer. Pancreas 33(3): 240-245, 2006

Lymph node ratio is an independent prognostic factor in node positive rectal cancer patients treated with preoperative chemoradiotherapy followed by curative resection. Asian Pacific Journal of Cancer Prevention 15(13): 5365-5369, 2015

Ratio between positive lymph nodes and total excised axillary lymph nodes as an independent prognostic factor for overall survival in patients with nonmetastatic lymph node-positive breast cancer. Indian Journal of Surgical Oncology 1(1): 68-75, 2010

The prognostic value of lymph node cross-sectional cancer area in node-positive breast cancer: a comparison with N stage and lymph node ratio. Pathology Research International 2012: 161964, 2012

Is lymph node ratio prognostic factor for survival in elderly patients with node positive breast cancer? The Anatolian Society of Medical Oncology. Annali Italiani di Chirurgia 84(2): 143-148, 2016

Prognostic implication of metastatic lymph node ratio in node-positive rectal cancer. Journal of the Korean Surgical Society 80(4): 260-266, 2011

Prognostic significance of the metastatic lymph node ratio in node-positive rectal cancer. Annals of Surgical Oncology 15(11): 3118-3123, 2008

Metastatic lymph node ratio is an independent prognostic factor in gastric cancer. Hepato-Gastroenterology 56(91-92): 908-913, 2009

Prognostic value of the lymph node ratio for lymph-node-positive breast cancer- is it just a denominator problem?. Springerplus 4: 121, 2015

The prognostic significance of the lymph node ratio in axillary lymph node positive breast cancer. Journal of Breast Cancer 14(3): 204-212, 2011

Prognostic value of lymph node ratio in node-positive breast cancer in Egyptian patients. Journal of the Egyptian National Cancer Institute 26(1): 31-35, 2014

Positive lymph node ratio is an independent prognostic factor in gastric cancer after d2 resection regardless of the examined number of lymph nodes. Annals of Surgical Oncology 16(2): 319-326, 2008