Lymph Node Ratio as a Risk Factor for Locoregional Recurrence in Breast Cancer Patients with 10 or More Axillary Nodes

被引:12
作者
Kim, Sang-Won [1 ]
Choi, Doo Ho [2 ]
Huh, Seung Jae [2 ]
Park, Won [2 ]
Nam, Seok Jin [3 ]
Kim, Seok Won [3 ]
Lee, Jeong Eon [3 ]
Im, Young-Hyuck [4 ]
Ahn, Jin Seok [4 ]
Park, Yeon Hee [4 ]
机构
[1] Ajou Univ, Sch Med, Dept Radiat Oncol, Suwon 441749, South Korea
[2] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Radiat Oncol, 81 Irwon Ro, Seoul 06351, South Korea
[3] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Surg, Seoul, South Korea
[4] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Div Hematol Oncol,Dept Med, Seoul, South Korea
关键词
Breast neoplasms; Local recurrence; Lymph node ratio; ADJUVANT CHEMOTHERAPY; PREMENOPAUSAL WOMEN; RADIATION-THERAPY; INTERNAL MAMMARY; RADIOTHERAPY; IRRADIATION; SURVIVAL; METAANALYSIS; DELINEATION; MASTECTOMY;
D O I
10.4048/jbc.2016.19.2.169
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
We analyzed the association of lymph node ratio (LNR) wth locoregional control (LRC) in breast cancer patients with >= 10 involved axillary lymph nodes who underwent multimodality treatment. Methods: We retrospectively analyzed 234 breast cancer patients with 10 involved axillary lymph nodes between 2000 and 2011. All patients received adjuvant chemotherapy and radiotherapy (RT) after radical surgery. The cutoff value of LNR was obtained using receiver operating characteristic curve analysis. The majority of patients (87.2%) received chemotherapeutic regimen including taxane. RT consisted of tangential fields to the chest wall or intact breast, delivered at a median dose of 50 Gy, and a single anterior port to the supraclavicular lymph node area, delivered at a median dose of 50 Gy. For patients who underwent breast-conserving surgery, an electron boost with a total dose of 9 to15 Gy was delivered to the tumor bed. Results: Within a median follow-up period of 73.5 months (range, 11-183 months), locoregional recurrence (LRR) occurred in 30 patients (12.8%) and the 5-year LRC rate was 88.8%. After multivariate analysis, LNR >= 0.7 was the only independent factor significantly associated with LRC (hazard ratio, 2.06; 95% confidence interval, 0.99-4.29; p=0.05). Conclusion: An aggressive multimodal treatment approach showed favorable locoregional outcome in patients with 10 involved axillary lymph nodes. However, patients with a high LNR >= 0.7 still had an increased risk for LRR, even in the setting of current local treatments.
引用
收藏
页码:169 / 175
页数:7
相关论文
共 50 条
[41]   Effect of breast-conserving surgery combined with sentinel lymph node biopsy and axillary preservation on the recurrence, metastasis, complications and cosmetic results of early breast cancer patients [J].
Xiang, Jing ;
Huang, Shiqin ;
Tuo, Youlin ;
Wang, Yun .
GLAND SURGERY, 2020, 9 (04) :1019-1025
[42]   Adjuvant chemotherapy for breast cancer patients with axillary lymph node micrometastases [J].
Hetterich, Madeleine ;
Gerken, Michael ;
Ortmann, Olaf ;
Inwald, Elisabeth C. ;
Klinkhammer-Schalke, Monika ;
Eggemann, Holm ;
Ignatov, Atanas .
BREAST CANCER RESEARCH AND TREATMENT, 2021, 187 (03) :715-727
[43]   Adjuvant chemotherapy for breast cancer patients with axillary lymph node micrometastases [J].
Madeleine Hetterich ;
Michael Gerken ;
Olaf Ortmann ;
Elisabeth C. Inwald ;
Monika Klinkhammer-Schalke ;
Holm Eggemann ;
Atanas Ignatov .
Breast Cancer Research and Treatment, 2021, 187 :715-727
[44]   Lymph Node Ratio is More Predictive than Traditional Lymph Node Stratification in Lymph Node Positive Invasive Breast Cancer [J].
Bai, Lian-Song ;
Chen, Chuang ;
Gong, Yi-Ping ;
Wei, Wen ;
Tu, Yi ;
Yao, Feng ;
Li, Juan-Juan ;
Wang, Li-Jun ;
Sun, Sheng-Rong .
ASIAN PACIFIC JOURNAL OF CANCER PREVENTION, 2013, 14 (02) :753-757
[45]   Intraoperative assessment of axillary lymph nodes in patients with breast cancer [J].
Dixon, J. Michael ;
Rutgers, Emiel ;
Hunt, Kelly K. .
BMJ-BRITISH MEDICAL JOURNAL, 2014, 349
[46]   Impact of Postmastectomy Radiation on Locoregional Recurrence in Breast Cancer Patients With 1-3 Positive Lymph Nodes Treated With Modern Systemic Therapy [J].
Tendulkar, Rahul D. ;
Rehman, Sana ;
Shukla, Monica E. ;
Reddy, Chandana A. ;
Moore, Halle ;
Budd, G. Thomas ;
Dietz, Jill ;
Crowe, Joseph P. ;
Macklis, Roger .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2012, 83 (05) :E577-E581
[47]   Development of a predictive score of axillary lymph node dissection based on targeted axillary dissection in patients with breast cancer diagnosis, affected lymph nodes, and neoadjuvant treatment [J].
Flores-Funes, Diego ;
Aguilar-Jimenez, Jose ;
Martinez-Galvez, Maria ;
Jose Ibanez-Ibanez, Maria ;
Carrasco-Gonzalez, Luis ;
Ignacio Gil-Izquierdo, Jose ;
Asuncion Chaves-Benito, Maria ;
Ayala-De La Pena, Francisco ;
Nieto-Olivares, Andres ;
Luis Aguayo-Albasini, Jose .
SURGICAL ONCOLOGY-OXFORD, 2021, 38
[48]   Value of lymph node ratio as a prognostic factor of recurrence in medullary thyroid cancer [J].
Hao, Weijing ;
Zhao, Jingzhu ;
Guo, Fengli ;
Gu, Pengfei ;
Zhang, Jinming ;
Huang, Dongmei ;
Ruan, Xianhui ;
Zeng, Yu ;
Zheng, Xiangqian ;
Gao, Ming .
PEERJ, 2023, 11
[49]   The impact of lymph node metastases on the survival of breast cancer patients with ten or more positive lymph nodes [J].
Tsuchiya, A ;
Kanno, M ;
Abe, R .
SURGERY TODAY, 1997, 27 (10) :902-906
[50]   The impact of lymph node metastases on the survival of breast cancer patients with ten or more positive lymph nodes [J].
Atsuo Tsuchiya ;
Masahiko Kanno ;
Rikiya Abe .
Surgery Today, 1997, 27 :902-906