Lymph Node Ratio (LNR): Predicting Prognosis after Neoadjuvant Chemotherapy (NAC) in Breast Cancer Patients

Soran, Atilla; Özmen, Tolga; Salamat, Arsalan; Soybir, Gürsel; Johnson, R. R.

doi:10.5152/ejbh.2019.4848

Cited by 14 publications

(17 citation statements)

References 32 publications

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“…25 In addition, another similar study, where TNBC accounted for 20.5%, reported a significant association between ypN +, OS, and DFS in the Cox regression. 26 However, when both ypN and LNR were included in the model, the LNR has a greater impact on DFS and OS [27][28][29][30] ; other studies reported that LNR was the only independent prognostic factor. 14,31 In our adjusted model, we found that the effect of ypN staging became nonsignificant.…”

Section: Discussionmentioning

confidence: 99%

Lymph node ratio as best prognostic factor in triple‐negative breast cancer patients with residual disease after neoadjuvant chemotherapy

et al. 2020

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Although lymph node status (ypN) is one of the most important prognostic factors of survival, the lymph node ratio (LNR) has emerged as an equitable factor. We aimed to compare the prognostic value of both ypN and LNR in patients with residual triplenegative breast cancer (TNBC) after neo-adjuvant chemotherapy (NAC). This was a How to cite this article: De la Cruz-Ku GA, Chambergo-Michilot D, Valcarcel B, et al. Lymph node ratio as best prognostic factor in triple-negative breast cancer patients with residual disease after neoadjuvant chemotherapy. Breast

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Section: Discussionmentioning

confidence: 99%

Lymph node ratio as best prognostic factor in triple‐negative breast cancer patients with residual disease after neoadjuvant chemotherapy

et al. 2020

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“…Several studies have proven that the LNR may serve as a better predictor of survival in patients with CRC because it is less affected by the total number of retrieved nodes [ 10 , 12 – 14 ]. Therefore, as an alternative or complementary method, LNR have been suggested for AJCC staging [ 15 ]. It aims to improve the prognosis for CRC by reducing the effect of heterogeneity of procedures on staging lymph nodes.…”

Section: Introductionmentioning

confidence: 99%

Log odds of positive lymph nodes as a novel prognostic predictor for colorectal cancer: a systematic review and meta-analysis

Zhang

et al. 2022

BMC Cancer

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Background Colorectal cancer (CRC) is the third most prevalent cancer in the world, which remains one of the leading causes of cancer-related deaths. Accurate prognosis prediction of CRC is pivotal to reduce the mortality and disease burden. Lymph node (LN) metastasis is one of the most commonly used criteria to predict prognosis in CRC patients. However, inaccurate surgical dissection and pathological evaluation may lead to inaccurate nodal staging, affecting the effectiveness of pathological N (pN) classification in survival prediction among patients with CRC. In this meta-analysis, we aimed to estimate the prognostic value of the log odds of positive lymph nodes (LODDS) in patients with CRC. Methods PubMed, Medline, Embase, Web of Science and the Cochrane Library were systematically searched for relevant studies from inception to July 3, 2021. Statistical analyses were performed on Stata statistical software Version 16.0 software. To statistically assess the prognostic effects of LODDS, we extracted the hazard ratio (HR) and 95% confidence interval (CI) of overall survival (OS) and disease-free survival (DFS) from the included studies. Results Ten eligible articles published in English involving 3523 cases were analyzed in this study. The results showed that LODDS1 and LODDS2 in CRC patients was correlated with poor OS compared with LODDS0 (LODDS1 vs. LODDS0: HR = 1.77, 95% CI (1.38, 2.28); LODDS2 vs. LODDS0: HR = 3.49, 95% CI (2.88, 4.23)). Meanwhile, LODDS1 and LODDS2 in CRC patients was correlated with poor DFS compared with LODDS0 (LODDS1 vs. LODDS0: HR = 1.82, 95% CI (1.23, 2.68); LODDS2 vs. LODDS0: HR =3.30, 95% CI (1.74, 6.27)). Conclusions The results demonstrated that the LODDS stage was associated with prognosis of CRC patients and could accurately predict the prognosis of patients with CRC.

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“…A bootstrap regression study from Geneva, Switzerland, introduced the 0.20, 0.65 cutoffs 21 . Numerous other studies have confirmed the superiority of the lymph node ratio and the cutoffs; we cite non exhaustively from the US, Korea, Netherlands, Italy, China, Turkey, in diverse conditions such as triple negative breast cancer 22 – 28 . There is neither anything new in the RMST.…”

Section: Discussionmentioning

confidence: 99%

Gini's mean difference and the long-term prognostic value of nodal quanta classes after pre-operative chemotherapy in advanced breast cancer

Vinh-Hung

Parijs

Gorobets

et al. 2022

Sci Rep

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Gini's mean difference (GMD, mean absolute difference between any two distinct quantities) of the restricted mean survival times (RMSTs, expectation of life at a given time limit) has been proposed as a new metric where higher GMD indicates better prognostic value. GMD is applied to the RMSTs at 25 years time-horizon to evaluate the long-term overall survival of women with breast cancer who received neoadjuvant chemotherapy, comparing a classification based on the number (pN) versus a classification based on the ratio (LNRc) of positive nodes found at axillary surgery. A total of 233 patients treated in 1980–2009 with documented number of positive nodes (npos) and number of nodes examined (ntot) were identified. The numbers were categorized into pN0, npos = 0; pN1, npos = [1,3]; pN2, npos = [4,9]; pN3, npos ≥ 10. The ratios npnx = npos/ntot were categorized into Lnr0, npnx = 0; Lnr1, npnx = (0,0.20]; Lnr2, npnx = (0.20,0.65]; Lnr3, npnx > 0.65. The GMD for pN-classification was 5.5 (standard error: ± 0.9) years, not much improved over a simple node-negative vs. node-positive that showed a GMD of 5.0 (± 1.4) years. The GMD for LNRc-classification was larger, 6.7 (± 0.8) years. Among other conventional metrics, Cox-model LNRc's c-index was 0.668 vs. pN's c = 0.641, indicating commensurate superiority of LNRc-classification. The usability of GMD-RMSTs warrants further investigation.

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Lymph Node Ratio (LNR): Predicting Prognosis after Neoadjuvant Chemotherapy (NAC) in Breast Cancer Patients

Cited by 14 publications

References 32 publications

Lymph node ratio as best prognostic factor in triple‐negative breast cancer patients with residual disease after neoadjuvant chemotherapy

Lymph node ratio as best prognostic factor in triple‐negative breast cancer patients with residual disease after neoadjuvant chemotherapy

Log odds of positive lymph nodes as a novel prognostic predictor for colorectal cancer: a systematic review and meta-analysis

Gini's mean difference and the long-term prognostic value of nodal quanta classes after pre-operative chemotherapy in advanced breast cancer

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