TY - JOUR
T1 - The prognostic value of lymph node cross-sectional cancer area in node-positive breast cancer
T2 - A comparison with N stage and lymph node ratio
AU - Li, Yanxia
AU - Holmes, Earle
AU - Shah, Karan
AU - Albuquerque, Kevin
AU - Szpaderska, Anna
AU - Erşahin, Çaatay
PY - 2012
Y1 - 2012
N2 - The number of positive axillary lymph nodes (LNs) is the only node-related factor for prognostic evaluation of breast cancer recognized by AJCC (TNM staging). However, N staging may not completely reflect LN tumor involvement due to the erroneous count of LNs in the presence of matted LNs and different tumor volume in LNs. Additionally, the positive/total LN ratio (LNR) has been shown to outperform N staging in survival prediction. In our study, to better quantify the tumor involvement of axillary LNs, we measured the cross-sectional cancer area (CSCA) of the positive LNs in 292 breast cancer patients diagnosed between 1998 and 2000 in our institution and compared its prognostic value to that of number of positive LNs (metLN)/N stage and LNR. Statistical analyses of these three LN-related factors were performed by Kaplan-Meier method and multivariate Cox's regression model. Patients were divided into three groups based on the different LN CSCA (50, 50-500, and >500 mm 2), or LNR (0.1, 0.1-0.65, and >0.65), or N stage (N1N3). Multivariate analysis demonstrated LNR was the most significant LN-related survival predictor with hazard ratio (HR) 25.0 (P=0.001), compared to the metLN (HR 0.09, P=0.052) and CSCA (HR 2.24, P=0.323).
AB - The number of positive axillary lymph nodes (LNs) is the only node-related factor for prognostic evaluation of breast cancer recognized by AJCC (TNM staging). However, N staging may not completely reflect LN tumor involvement due to the erroneous count of LNs in the presence of matted LNs and different tumor volume in LNs. Additionally, the positive/total LN ratio (LNR) has been shown to outperform N staging in survival prediction. In our study, to better quantify the tumor involvement of axillary LNs, we measured the cross-sectional cancer area (CSCA) of the positive LNs in 292 breast cancer patients diagnosed between 1998 and 2000 in our institution and compared its prognostic value to that of number of positive LNs (metLN)/N stage and LNR. Statistical analyses of these three LN-related factors were performed by Kaplan-Meier method and multivariate Cox's regression model. Patients were divided into three groups based on the different LN CSCA (50, 50-500, and >500 mm 2), or LNR (0.1, 0.1-0.65, and >0.65), or N stage (N1N3). Multivariate analysis demonstrated LNR was the most significant LN-related survival predictor with hazard ratio (HR) 25.0 (P=0.001), compared to the metLN (HR 0.09, P=0.052) and CSCA (HR 2.24, P=0.323).
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U2 - 10.1155/2012/161964
DO - 10.1155/2012/161964
M3 - Article
C2 - 23094198
AN - SCOPUS:84867952398
SN - 2042-003X
VL - 2012
JO - Pathology Research International
JF - Pathology Research International
M1 - 161964
ER -