Prognostic value of post-mastectomy radiation therapy in node-positive breast cancer patients treated with breast conservation therapy
10.3969/j.issn.1000-8179.20131848
- VernacularTitle:保乳术后放疗对乳腺癌局部淋巴结转移患者预后的影响
- Author:
Ying ZHENG
;
Qin CHEN
;
Miaomiao JIA
;
Zhijie LIANG
;
Xuchen CAO
- Publication Type:Journal Article
- Keywords:
breast cancer;
breast conservation surgery;
lymph node ratio;
PMRT
- From:
Chinese Journal of Clinical Oncology
2014;(21):1394-1398
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the prognostic value of post-mastectomy radiation therapy (PMRT) in patients with axillary lymph node-positive breast cancer treated with breast conservation surgery and to establish the candidates for PMRT based on different pN stages and lymph node ratios (LNR). Methods:A retrospective analysis of the clinical data of the patients was conducted. The pa-tients had positive lymph nodes (n=152) between 1998 and 2007 and underwent breast conservation surgery. A comparison of the dis-ease-free survival (DFS) and overall survival (OS) rates was conducted based on LNR and pN staging and with PMRT as a prognostic factor. Results:A total of 152 cases were studied, of which 114 were pN1, 23 were pN2, and 15 were pN3. Among these cases, 114 had an LNR ranging from 0.01 to 0.20, 26 had an LNR from 0.21 to 0.65, and 12 had an LNR>0.65. Univariate analysis showed that the number of dissected lymph nodes, LNR, pN stage, estrogen and progesterone receptor status, and radiotherapy were the prognostic fac-tors for DFS and OS rates (P<0.05). Age and chemotherapy were prognostic factors only for OS rate (P<0.05). Multivariate analysis in-dicated that PMRT and LNR were independent prognostic factors of DFS and OS (P<0.05). The pN staging had no significant effect on DFS or OS (P>0.05). In the subgroup analysis, PMRT had significant effect on DFS and OS (P<0.05) in patients with pN1 and LNR<0.21. Conclusion:LNR is an independent prognostic factor in axillary lymph node-positive breast cancer patients treated with breast conservation surgery, and a candidate for PMRT should be established based on different LNR risks.
