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[Prognostic value of metastatic axillary lymph node ratio in node-positive breast cancer treated by breast conserving surgery].

OBJECTIVE
To evaluate the prognostic value of lymph node ratio (LNR) as compared with the number of pN staging in patients with axillary lymph node-positive breast cancer treated by breast conserving surgery.


METHODS
We performed a retrospective analysis of the clinical data of patients who received breast conserving surgery and with positive lymph nodes (n = 152) between 1998 and 2007. The disease-free survival (DFS) and overall survival (OS) were compared based on the LNR and pN staging.


RESULTS
A total of 152 patients were classified as pN1 in 114, pN2 in 23, and pN3 in 15 cases. Among the 152 cases, 114 cases had a LNR ≤ 0.20, 26 cases had 0.21-0.65, and 12 cases had a LNR>0.65. Univariate analysis showed that number of dissected lymph nodes, LNR, pN stage, ER/PR status and radiotherapy were significant prognostic factors for DFS and OS (P < 0.05 for all). Age and chemotherapy were prognostic factors only for OS (P < 0.05). Multivariate analysis indicated that LNR was an independent prognostic factor for DFS and OS (P < 0.05 for both). pN stage had no significant effect on DFS or OS (P > 0.05 for both). In the pN subgroup analysis, LNR was also showed to be significantly correlated with the prognosis of patients.


CONCLUSIONS
LNR is superior to pN staging as a prognostic factor in axillary lymph node-positive breast cancer patients treated by breast conservation surgery, and can be used as one of independent prognostic predictors for the patients.