Abstract 3728
Background
The purpose of this study was to evaluate the prognostic value of nodal ratio compared to the absolute number of positive lymph nodes in patients with ≥4 positives nodes early-stage breast cancer.
Methods
Between 2010-2015, we identified 111 patients with early-stage pN2-N3 breast cancer. All patients were treated with curative intent and had at least 8 resected lymph nodes. We calculated nodal ratio (NR=positive over excised lymph nodes) for each patient. Several prognostic factors were evaluated. The Cox proportional hazard model was used to evaluate the prognostic significance for relapse-free survival and overall survival.
Results
Median age was 50 years old. Lymph node involvement was pN2 in 61.3% of cases and pN3 in 38.7% of cases. Median tumor size was 46 mm. Hormonal receptors were positive in 73.9% of cases. Her2 Neu was overexpressed in 32.4% of cases. Relapse rate was 34.2% (locoregional 36.2%, metastatic in 63.8%). After a median follow-up of 44 months, we did not observe any difference in terms of relapse rate (30% vs 40%, p = 0.19), time to relapse (25 months, p = 0.94), relapse-free survival and overall survival according to absolute number of involved lymph nodes (pN2 vs pN3 groups). NR ≥ 60% was significantly correlated with relapse rate (24% vs 53%, p = 0.02). There was no impact of NR on time to relapse (24 vs 26 months p = 0.81). In univariate analysis we observed a significant difference in 5-year relapse-free survival between patients with NR < 60% vs NR ≥ 60% (59% vs 49%, p = 0.04). In multivariate analysis including: grade, hormonal receptors, HER2, Ki67, we observed that NR was as an independent prognostic factor for relapse-free survival. There was no impact on overall survival.
Conclusions
NR ≥ 60% predicted relapse-free survival better than the absolute number of involved lymph nodes in pN2 and pN3 early-stage breast cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Abderrahmen Mami Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
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