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• W2243375603 abstract "10584 Background: Among TNM staging criteria, the number of positive lymph nodes [PNOD] is the strongest predictor of patient outcome. Based on SEER data, Vinh Hung (2004) asserted that the ratio of the number of positive nodes to the number of nodes removed [NODR] may better predict outcome. We evaluated this assertion in patients from 13 node-positive NSABP phase III trials. Methods: The impact of PNOD, its logarithm (LPNOD) and NODR on survival (S) and recurrence free survival (RFS) were assessed via Cox PH models in 19,768 patients with node-positive breast cancer in 13 NSABP clinical trials. The cohort was split into 2 groups: 9 older trials (Protocols B-05, B-07, B-08, B-09, B-10, B-11, B-12, B-15 and B-16) consisting of 9,915 patients and 4 newer trials (B-22, B-25, B-28 and B-31) consisting of 9,853 patients. Only randomized eligible patients with follow-up were considered. Models were fit to the outcomes for the older trials and validated in the newer trials. Results were adjusted for age, protocol and tumor size. We used Wald z-scores, Nagelkerke R 2 , and residual analyses to assess the strength of the relationship between nodal status and outcomes. Results: Median time on study was 19.8 years in the older trials and 10.6 years in the newer trials. Ten-year models across the protocols revealed that the relative hazard ratio for each of the outcomes studies was logarithmic according to the number of positive nodes for = 30 positive nodes. Using LPNOD and NODR compared to PNOD improved the strength of association but did not greatly improve goodness of fit ( Table 1 1). For all endpoints, the strength of association and goodness of fit associated with nodal status and other TNM factors attenuated in newer protocols. Conclusions: Nodal status and other TNM factors currently used for breast cancer staging continue to be strong indicators of patient prognosis. However, these factors should be augmented to account for new genetic and biological markers. [Table: see text] No significant financial relationships to disclose." @default.
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• W2243375603 date "2007-06-20" @default.
• W2243375603 modified "2023-09-27" @default.
• W2243375603 title "Rethinking the role of nodal status in TNM staging of node-positive breast cancer" @default.
• W2243375603 doi "https://doi.org/10.1200/jco.2007.25.18_suppl.10584" @default.
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