TY - JOUR
T1 - Prognostic role of lymph-node level involvement in patients undergoing axillary dissection for breast cancer
AU - Canavese, Giuseppe
AU - Catturich, Alessandra
AU - Vecchio, Carlo
AU - Tomei, Daniela
AU - Gipponi, Marco
AU - Bruzzi, Paolo
AU - Badellino, Fausto
PY - 1998
Y1 - 1998
N2 - Aims. Clinical records of patients undergoing surgery for breast cancer were reviewed in order to evaluate the prognostic role of lymph-node level involvement. Methods. From 1982 to 1991, 1143 patients had radical mastectomy or conservative surgery with total axillary dissection: 461 patients of mean age 57.1 years (range: 25-89 years) were lymph-node positive (pN1); 369 patients (80%) had radical mastectomy; and 92 patients (20%) had conservative treatment plus post-operative radiotherapy, with the same mean number (n = 16) of lymph nodes collected in the surgical specimen. Data were analysed for the number of positive lymph nodes and level of involvement. Results. Level I, Levels I+II and Levels I+II+III were involved in 44.9, 18 and 21.4% of patients, respectively; 'skip metastases' occurred in 72 of 451 pN1 patients (15.5%). A univariate analysis showed that prognosis was directly related to the number of levels involved (P <0.001), and skip metastases had the same prognostic role as Level I involvement. The numbers of involved lymph-node levels and metastatic lymph nodes were well correlated; multivariate analysis showed that involvement of Levels I and III was independently correlated with prognosis. After adjustment for age and number of positive lymph nodes, the number of involved lymph-node levels was an independent prognostic factor, with highest predictability when all three lymph-node levels were positive (P = 0.009). Conclusions. The prognostic value of lymph-node status should be defined not only by the number of metastatic lymph nodes, but also by the number of levels of involvement.
AB - Aims. Clinical records of patients undergoing surgery for breast cancer were reviewed in order to evaluate the prognostic role of lymph-node level involvement. Methods. From 1982 to 1991, 1143 patients had radical mastectomy or conservative surgery with total axillary dissection: 461 patients of mean age 57.1 years (range: 25-89 years) were lymph-node positive (pN1); 369 patients (80%) had radical mastectomy; and 92 patients (20%) had conservative treatment plus post-operative radiotherapy, with the same mean number (n = 16) of lymph nodes collected in the surgical specimen. Data were analysed for the number of positive lymph nodes and level of involvement. Results. Level I, Levels I+II and Levels I+II+III were involved in 44.9, 18 and 21.4% of patients, respectively; 'skip metastases' occurred in 72 of 451 pN1 patients (15.5%). A univariate analysis showed that prognosis was directly related to the number of levels involved (P <0.001), and skip metastases had the same prognostic role as Level I involvement. The numbers of involved lymph-node levels and metastatic lymph nodes were well correlated; multivariate analysis showed that involvement of Levels I and III was independently correlated with prognosis. After adjustment for age and number of positive lymph nodes, the number of involved lymph-node levels was an independent prognostic factor, with highest predictability when all three lymph-node levels were positive (P = 0.009). Conclusions. The prognostic value of lymph-node status should be defined not only by the number of metastatic lymph nodes, but also by the number of levels of involvement.
KW - Breast cancer
KW - Lymph-node level
KW - Prognosis
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U2 - 10.1016/S0748-7983(98)91381-6
DO - 10.1016/S0748-7983(98)91381-6
M3 - Article
C2 - 9591024
AN - SCOPUS:0031926276
VL - 24
SP - 104
EP - 109
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
IS - 2
ER -