Occult XXXX burden predicts disease recurrence in lymph node-negative @entity14 .

@entity1 @entity19269 @entity5 @entity3 @entity14
PURPOSE: Lymph node involvement by histopathology informs @entity14 prognosis, whereas recurrence in 25% of node-negative @entity1 suggests the presence of occult @entity3 . @entity19269 ( @entity19269 ) is a marker of @entity14 cells that identifies occult nodal metastases associated with recurrence risk. Here, we defined the association of @entity5 burden, quantified by @entity19269 reverse transcriptase-PCR (RT-PCR), with outcomes in @entity14 . EXPERIMENTAL DESIGN: Lymph nodes (range: 2-159) from 291 prospectively enrolled node-negative @entity14 @entity1 were analyzed by histopathology and @entity19269 quantitative RT-PCR. @entity1 were followed for a median of 24 months (range: 2-63). Time to recurrence and disease-free survival served as primary and secondary outcomes, respectively. Association of outcomes with prognostic markers, including molecular @entity5 burden, was estimated by recursive partitioning and Cox models. RESULTS: In this cohort, 176 (60%) @entity1 exhibited @entity5 burden (Mol(Low)), and all but four remained free of disease [recurrence rate 2.3% (95% CI, 0.1-4.5%)]. Also, 90 (31%) @entity1 exhibited intermediate @entity5 burden (Mol(Int)) and 30 [33.3% (23.7-44.1)] developed recurrent disease. Furthermore, 25 (9%) @entity1 exhibited @entity5 burden (Mol(High)) and 17 [68.0% (46.5-85.1)] developed recurrent disease (P < 0.001). Occult @entity5 burden was an independent marker of prognosis. Mol(Int) and Mol(High) @entity1 exhibited a graded risk of earlier time to recurrence [Mol(Int), adjusted HR 25.52 (11.08-143.18); P < 0.001; Mol(High), 65.38 (39.01-676.94); P < 0.001] and reduced disease-free survival [Mol(Int), 9.77 (6.26-87.26); P < 0.001; Mol(High), 22.97 (21.59-316.16); P < 0.001]. CONCLUSION: Molecular @entity5 burden in lymph nodes is independently associated with time to recurrence and disease-free survival in @entity1 with node-negative @entity14 .
