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  • [Cancers (Basel).] Clinical Significance of Lymph-Node Ratio in Determining Supraclavicular Lymph-Node Radiation Therapy in pN1 Breast Cancer Patients Who Received Breast-Conserving Treatment (KROG 14-18): A Multicenter Study.유방보존술을 받은 pN1 유방암 환자에서 쇄골위방사선치료 결정과정에서 Lymph-Node Ratio 의 임상적 의미 (KROG 14-18)

    계명의대/김재호,박원,김진희*

  • 출처
    Cancers (Basel).
  • 등재일
    2019 May 16
  • 저널이슈번호
    11(5). pii: E680. doi: 10.3390/cancers11050680.
  • 내용

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    Abstract
    This study evaluated the clinical significance of the lymph-node ratio (LNR) and its usefulness as an indicator of supraclavicular lymph-node radiation therapy (SCNRT) in pN1 breast cancer patients with disease-free survival (DFS) outcomes. We retrospectively analyzed the clinical data of patients with pN1 breast cancer who underwent partial mastectomy and taxane-based sequential adjuvant chemotherapy with postoperative radiation therapy in 12 hospitals (n = 1121). We compared their DFS according to LNR, with a cut-off value of 0.10. The median follow-up period was 66 months (range, 3-112). Treatment failed in 73 patients (6.5%) and there was no significant difference in DFS between the SCNRT group and non-SCNRT group. High LNR (>0.10) showed significantly worse DFS in both univariate and multivariate analyses (0.010 and 0.033, respectively). In a subgroup analysis, the effect of SCNRT on DFS differed significantly among patients with LNR > 0.10 (p = 0.013). High LNR can be used as an independent prognostic factor for pN1 breast cancer patients treated with partial mastectomy and postoperative radiotherapy. It may also be useful in deciding whether to perform SCNRT to improve DFS.

     


    Author information

    Kim J1, Park W2, Kim JH3, Choi DH4, Kim YJ5, Lee ES6, Shin KH7, Kim JH8, Kim K9, Kim YB10, Ahn SJ11, Lee JH12, Chun M13, Lee HS14, Kim JS15, Cha J16.
    1
    Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu 42601, Korea. rainfield@naver.com.
    2
    Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea. wonro.park@samsung.com.
    3
    Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu 42601, Korea. jhkim@dsmc.or.kr.
    4
    Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea. dohochoi@hanmail.net.
    5
    Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang 10408, Korea. jane2000md@gmail.com.
    6
    Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang 10408, Korea. eslee@ncc.re.kr.
    7
    Department of Radiation Oncology, Seoul National University College of Medicine, Seoul 03080, Korea. radiat@snu.ac.kr.
    8
    Department of Radiation Oncology, Seoul National University College of Medicine, Seoul 03080, Korea. jinho.kim.md@gmail.com.
    9
    Department of Radiation Oncology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul 07804, Korea. kyubokim.ro@gmail.com.
    10
    Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul 03722, Korea. ybkim3@yuhs.ac.
    11
    Department of Radiation Oncology, Chonnam National University Medical School, Gwangju 61469, Korea. ahnsja@chonnam.ac.kr.
    12
    Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine, Seoul 06591, Korea. koppul@catholic.ac.kr.
    13
    Department of Radiation Oncology, Ajou University School of Medicine, Suwon 16499, Korea. chunm@ajou.ac.kr.
    14
    Department of Radiation Oncology, Dong-A University Hospital, Dong-A University School of Medicine, Busan 49201, Korea. hyslee@dau.ac.kr.
    15
    Department of Radiation Oncology, Chonbuk National University Medical School, Jeonju 54907, Korea. jskim@chonbuk.ac.kr.
    16
    Department of Radiation Oncology, Wonju Severance Christian Hospital, Wonju 26426, Korea. lukanus@yonsei.ac.kr.

  • 키워드
    breast cancer; disease-free survival; lymph-node ratio; radiotherapy
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