The lymph node ratio as an independent prognostic factor for non-metastatic XXXX recurrence and mortality.

@entity1 @entity5 @entity0 @entity3
PURPOSE: To examine the prognostic value of lymph node ratio (LNR) in pathological nodal (pN) stage @entity0 @entity1 . Also, to analyse additional clinical and pathologic prognostic factors and the impact of LNR among molecular subtypes. METHODS: Among a total of 3088 @entity1 , 1004 @entity1 with non-metastatic @entity0 were analysed. The @entity1 were classified into low ( <=0.20), intermediate (0.20 to 0.65) and high-risk (>0.65) LNR groups. Univariate and multivariate Cox proportional hazards regression model for disease-free survival (DFS), and overall survival (OS) were performed to evaluate the prognostic value of LNR. RESULTS: The median LNR was 0.17 (range 0.02-1.00). Of the @entity1 , 55.7% were in low, 32.1% in intermediate, and 12.3% in high risk group. When compared with low risk group, high risk group had more often large @entity5 size and high grade @entity5 with @entity3 . The median follow-up period was 46.8 months. The 5-year @entity0 and DFS rates for @entity1 with low, intermediate, and high were 88%-67%, 65%-48% and 53%-24%, respectively (both plog-rank < 0.0001). On multivariate analysis, pN stage and LNR were both independent predictors of survival, however, an overlapping between N1 (250 months, 95% confidence interval [CI] 88.15-413.21 ) and N2 (176 months, 95% CI 129.51-222.93) curves in pN staging was determined. We also observed clear prognostic separation for triple negative @entity0 with LNR survival over pN staging. CONCLUSION: The LNR predicts survival more accurately than pN staging in @entity0 @entity1 . The use of LNR may standardize the staging and guide decisions for adjuvant treatments.
