Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 558
© 2004 American Society of Clinical Oncology

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Schaapveld, M. Articles by B. Willemse, P. H. Search for Related Content PubMed Articles by Schaapveld, M. Articles by B. Willemse, P. H.

Abstract

The number of histologically examined axillary lymph nodes can improve the prediction of individual prognosis of primary breast cancer patients

Comprehensive Cancer Center North, Groningen, Netherlands; University Hospital, Groningen, Netherlands

558

Background: A minimal number of histologically examined nodes has been associated with improved survival in both node-negative and node-positive patients. Following a retrospective audit of quality of axillary staging, the prognostic effect of variation in the number of histologically examined nodes was assessed by the CCCN regional cancer registry. Methods: From January 1994 until January 1999, 5314 consecutive surgically treated breast cancer patients receiving an axillary dissection were included. Patients were followed until January 2003. Survival was estimated by the Kaplan-Meier method, survival distributions were compared by a log rank test. Relative survival was estimated by the Hakulinen-Tenkanen approach. Using Cox Proportional Hazard analysis (CPH) the effects of number of examined nodes and other prognostic variables including age, tumor size, tumor grade, the number of positive nodes and mode of tumor detection were assessed. Results: Of 5314 patients included, 59% was node-negative. A median number of 12 (range 1–43) nodes were examined, this number decreased with age (p<0.001) and increased with tumor size (p< 0.001). Median follow-up was 6 years for patients alive at last contact. A total of 1161 patient (22%) had died. Table 1 shows the results of a univariate survival analysis and stratified for the number of positive nodes Overall p< 0.0009; CS=crude survival; RS=relative survival; CI=confidence interval Conclusion: CPH analysis stratified for nodal status showed, that the number of examined nodes was an independent prognostic factor, in node negative as well as node-positive patients. Every five-node increase was associated with a 10% lower hazard of dying. Systemic adjuvant treatment (SAT) was not included as a variable in the CPH analysis as >95% of node positive patients and only 8% of node-negative patients received SAT.

View larger version (23K): [in this window] [in a new window]

Abstract presentation from the 2004 ASCO Annual Meeting