Department of Radiation Oncology, Faculty of Medicine, Marmara University, Istanbul, Turkey.
Anadolu Medical Center, Gebze, Kocaeli, Turkey.
J Cancer Res Ther. 2020 Oct-Dec;16(6):1387-1392. doi: 10.4103/jcrt.JCRT_1034_19.
This study assessed whether prognostic information could be obtained in patients with lymph node (LN)-positive breast cancer based on their LN ratios (LNRs) and explored the relationships between other potential prognostic factors and survival.
This was a retrospective clinical study.
This study included 608 women with node-positive nonmetastatic breast cancer. Clinical and pathologic data were retrospectively evaluated. The median age was 51 years (range: 23-84 years). All patients received adjuvant radiotherapy after radical surgery. A total dose of 50 Gy was administered to the chest wall or breast and LN regions with 2 Gy daily fractions. A 10-Gy boost was administered to the breast tumor bed. The cutoff value of LNR was defined as low risk (<0.21) in 278 patients, intermediate risk (0.21-0.65) in 217 patients, and high risk (>0.65) in 113 patients. Prognostic variables included patient characteristics, disease characteristics, and interventional factors. The primary endpoint was overall survival and the secondary endpoint was breast cancer-related mortality.
Statistical analyses were performed using the Kaplan-Meier method, log-rank test, and Cox regression analysis. P value was required to be <0.05.
Within a median follow-up period of 95.4 months (range: 5-232.4 months), overall survival rates for 10 and 15 years were 66% and 53%, respectively. Multivariate analysis revealed that LNR (P = 0.026), estrogen receptor status (ERS) (P = 0.021), age (P = 0.04), and smoking (P = 0.024) were independent significant prognostic factors for overall survival. Breast cancer-related mortality rates at 10 and 15 years were 70.7% and 60%, respectively. LNR (P = 0.03) and ERS (P = 0.002) were independent significant prognostic factors for breast cancer-related mortality.
LNR and ERS were significant prognostic factors for survival at all endpoints.
本研究旨在评估基于淋巴结阳性乳腺癌患者的淋巴结比值（LNR）是否可以获得预后信息，并探讨其他潜在预后因素与生存之间的关系。
这是一项回顾性临床研究。
本研究纳入了 608 例淋巴结阳性非转移性乳腺癌患者。回顾性评估临床和病理数据。中位年龄为 51 岁（范围：23-84 岁）。所有患者在根治性手术后均接受辅助放疗。胸壁或乳房和淋巴结区域给予 50 Gy 总剂量，每日 2 Gy 分次。对乳房肿瘤床给予 10 Gy 加量。将 LNR 的截断值定义为低危（<0.21）278 例，中危（0.21-0.65）217 例，高危（>0.65）113 例。预后变量包括患者特征、疾病特征和干预因素。主要终点是总生存，次要终点是乳腺癌相关死亡率。
使用 Kaplan-Meier 法、对数秩检验和 Cox 回归分析进行统计分析。要求 P 值<0.05。
在中位随访期 95.4 个月（范围：5-232.4 个月）内，10 年和 15 年总生存率分别为 66%和 53%。多因素分析显示，LNR（P=0.026）、雌激素受体状态（ERS）（P=0.021）、年龄（P=0.04）和吸烟（P=0.024）是总生存的独立显著预后因素。10 年和 15 年乳腺癌相关死亡率分别为 70.7%和 60%。LNR（P=0.03）和 ERS（P=0.002）是乳腺癌相关死亡率的独立显著预后因素。
LNR 和 ERS 是所有终点生存的显著预后因素。
