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Poster display - Cocktail

890 - Prognostic Nomogram Based on Lymph Node Ratio to Predict Survival in Node-Positive Breast Cancer Patients Treated With Neoadjuvant Chemotherapy


24 Nov 2018


Poster display - Cocktail


Cytotoxic Therapy;  Pathology/Molecular Biology

Tumour Site

Breast Cancer


Jianguo Lai


Annals of Oncology (2018) 29 (suppl_9): ix8-ix12. 10.1093/annonc/mdy427


J. Lai1, J. Peng2, H. Deng1, P. Chen3, G. Ye3, F. Yu1, F. Su1, K. Chen1, Z. Pan1

Author affiliations

  • 1 Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120 - Guangzhou/CN
  • 2 Department Of Rehabilitation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 510120 - Guangzhou/CN
  • 3 Department Of Breast Surgery, the First People’s Hospital of Foshan, 528000 - Foshan/CN


Abstract 890


In the past decade, previous studies have suggested that lymph node ratio (LNR, ratio of involved over dissected lymph nodes) was a superior predictor for survival compared with ypN staging. However, few authors have incorporated the prognostic value of LNR to improve individualized estimates of survival in node-positive breast cancer (BC) patients after neoadjuvant chemotherapy (NACT).


Data from 339 node-positive BC patients after NACT from two independent centers were retrospectively collected. A prognostic model incorporating LNR was built to predict disease-free survival (DFS) based on the Cox proportional hazards model. The discrimination, calibration ability, and clinical utility of the nomogram were evaluated by C-index, calibration curve, risk group stratification, and decision curve analysis (DCA) and were compared with the TNM staging system.


Independent prognostic factors for DFS were age, pathological T stage, LNR, histological grade, ER, Ki67, and lymphovascular invasion, which were all entered into the nomogram. The C-index of the nomogram for predicting DFS was 0.773, which was higher than that of the TNM staging system (C-index: 0.610). The calibration curve indicated close agreement between nomogram predictions and actual observations. Based on the risk group stratification of the nomogram, Kaplan-Meier curves demonstrated significant differences between the low-risk and high-risk patients (p < 0.0001).


The LNR-based nomogram provided more accurate individualized risk prediction of DFS in node-positive BC patients after NACT. This practical tool may assist oncologists in selecting the high-risk patients who are in need of a specific treatment strategy.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Sun Yat-sen Memorial Hospital, Sun Yat-sen University.


Has not received any funding.


All authors have declared no conflicts of interest.

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