Please use this identifier to cite or link to this item: https://doi.org/10.1200/JCO.2008.18.6965
Title: Lymph node ratio as an alternative to pN staging in node-positive breast cancer
Authors: Vinh-Hung, V.
Verkooijen, H.M. 
Fioretta, G.
Neyroud-Caspar, I.
Rapiti, E.
Vlastos, G.
Deglise, C.
Usel, M.
Lutz, J.-M.
Bouchardy, C.
Issue Date: 1-Mar-2009
Citation: Vinh-Hung, V., Verkooijen, H.M., Fioretta, G., Neyroud-Caspar, I., Rapiti, E., Vlastos, G., Deglise, C., Usel, M., Lutz, J.-M., Bouchardy, C. (2009-03-01). Lymph node ratio as an alternative to pN staging in node-positive breast cancer. Journal of Clinical Oncology 27 (7) : 1062-1068. ScholarBank@NUS Repository. https://doi.org/10.1200/JCO.2008.18.6965
Abstract: Purpose In the current pTNM classification system, nodal status of breast cancer is based on the number of involved lymph nodes and does not account for the total number of lymph nodes removed. In this study, we assessed the prognostic value of the lymph node ratio (LNR; ie, ratio of positive over excised lymph nodes) as compared with pN staging and determined its optimal cutoff points. Patients and Methods From the Geneva Cancer Registry, we identified all women diagnosed with node-positive breast cancer between 1980 and 2004 (n = 1,829). The prognostic value of LNRs was calculated for values ranging from 0.05 to 0.95 by Cox regression analysis and validated by bootstrapping. Based on maximum likelihood, we identified cutoff points classifying women into low-, intermediate-, and high-risk LNR groups. Results Optimal cutoff points classified patients into low- (≤ 0.20), intermediate- (> 0.20 and ≤ 0.65), and high-risk (> 0.65) LNR groups, corresponding to 10-year disease-specific survival rates of 75%, 63%, and 40%, and adjusted mortality risks of 1 (reference), 1.78 (95% CI, 1.46 to 2.18), and 3.21 (95% CI, 2.54 to 4.06), respectively. In contrast to LNR risk categories, survival curves of pN2 and pN3 crossed after 15 years, and their adjusted mortality risks showed overlapping CIs: 2.07 (95% CI, 1.69 to 2.53) and 2.84 (95% CI, 2.23 to 3.61), respectively. Conclusion LNR predicts survival after breast cancer more accurately than pN classification and should be considered as an alternative to pN staging. © 2009 by American Society of Clinical Oncology.
Source Title: Journal of Clinical Oncology
URI: http://scholarbank.nus.edu.sg/handle/10635/109450
ISSN: 0732183X
DOI: 10.1200/JCO.2008.18.6965
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

SCOPUSTM   
Citations

187
checked on Feb 3, 2023

WEB OF SCIENCETM
Citations

183
checked on Feb 3, 2023

Page view(s)

148
checked on Feb 2, 2023

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.