Superiority of Pathologic Lymph Node Ratio over Positive Lymph Node Count in Operated Early-Stage Breast Cancer

Basit Öğe Kaydı
dc.contributor.authorUrakci, Zuhat
dc.contributor.authorKaplan, Muhammet Ali
dc.contributor.authorOruc, Zeynep
dc.contributor.authorGumus, Mahmut
dc.contributor.authorUncu, Dogan
dc.contributor.authorEbinc, Senar
dc.contributor.authorOzkan, Metin
dc.date.accessioned2026-04-04T13:30:40Z
dc.date.available2026-04-04T13:30:40Z
dc.date.issued2024
dc.departmentİnönü Üniversitesi
dc.description.abstractAIM: In early-stage breast cancer, the axillary lymph nodes play a crucial role in determining the prognosis of the disease. The rate of lymph node involvement might be a more valuable prognostic factor than the number of positive lymph nodes. Therefore, we aimed to evaluate whether the lymph node ratio (LNR) is a superior prognostic indicator compared to the pathologic lymph node count in early-stage disease. METHODS: We included 3053 non-metastatic, lymph node-positive breast cancer patients who were treated and followed at 6 medical oncology centers in Turkiye between 2004-2018. Based on LNR, patients were classified into three risk groups: high (>0.65), intermediate (0.21-0.65), and low (<= 0.20). RESULTS: Classification of patients according to the TNM8 system based on the number of positive lymph nodes revealed that pathologic lymph node count (pN)1 accounted for 49.0% (n = 1495), pN2 for 30.0% (n = 917), and pN3 for 21.0% (n = 641). Based on the LNR risk group, the low-risk group accounted for 45.4% (n = 1385), intermediate for 36.2% (n = 1105), and high for 18.4% (n = 563) of the total patients. For the entire patient cohort, the 5- and 10-year disease-free survival (DFS) were 93% and 67%, respectively, while overall survival (OS) rates were 95% and 75%, respectively. The median DFS for patients with N1, N2, and N3 disease was 149 months (94.2-203.7), 120.1 months (108.2-132.0), and 81.8 months (68.4-131.1), respectively (p < 0.001). The median DFS for the three LNR risk groups (low, intermediate, and high risk) was 148.9 months (95.3-202.6), 118.7 months (99.9-137.7), and 81.8 months (68.2-95.3) respectively. Increasing LNR rate was an independent prognostic factor for DFS, according to multivariate analysis (p < 0.001). Furthermore, the median DFS was 133 months for pathologic N1 patients in the LNR intermediate-high risk group, while the median DFS was not reached in patients with LNR and the pN2 low risk group (p = 0.034). CONCLUSIONS: This study confirms the significance of LNR as a prognostic factor for DFS. The results show that in certain specific subgroups, LNR provides more information than pathologic lymph node counts.
dc.identifier.doi10.62713/aic.3319
dc.identifier.endpage1177
dc.identifier.issn0003-469X
dc.identifier.issn2239-253X
dc.identifier.issue6
dc.identifier.orcid0000-0003-3550-9993
dc.identifier.orcid0000-0002-3982-7465
dc.identifier.pmid39723526
dc.identifier.scopus2-s2.0-85213413595
dc.identifier.scopusqualityQ3
dc.identifier.startpage1170
dc.identifier.urihttps://doi.org/10.62713/aic.3319
dc.identifier.urihttps://hdl.handle.net/11616/108282
dc.identifier.volume95
dc.identifier.wosWOS:001418456800020
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherEdizioni Luigi Pozzi
dc.relation.ispartofAnnali Italiani Di Chirurgia
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20250329
dc.subjectbreast cancer
dc.subjectearly-stage breast cancer
dc.subjectlymph node ratio
dc.subjectpathologic lymph node staging
dc.subjectprognosis
dc.subjectlymph node count
dc.titleSuperiority of Pathologic Lymph Node Ratio over Positive Lymph Node Count in Operated Early-Stage Breast Cancer
dc.typeArticle

Dosyalar

Koleksiyon

WoS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu
Scopus İndeksli Yayınlar Koleksiyonu