The appropriate number of ELNs for lymph node negative breast cancer patients underwent MRM: a population-based study

Negative Lymph Node Count and Lymph Node Ratio Are Associated With Survival in Male Breast Cancer

BACKGROUND

Male breast cancer (MBC) is usually diagnosed at late stages and therefore has a worse prognosis than female breast cancer (FBC). MBC is also more likely to have lymph node (LN) involvement than FBC.

MATERIALS AND METHODS

We sought to determine the prognostic role of the examined lymph node (LN), negative LN (NLN), and positive LN counts and the LN ratio (LNR), defined as (positive LNs/ENLs), on the survival rate among MBC patients. We performed a large population-based study using the data from the Surveillance, Epidemiology, and End Results program.

RESULTS

Older age, black race, stage IV disease, ≤ 1 NLN, and a > 31.3% LNR were significantly associated with worse survival across all prediction models. Moreover, we demonstrated a decreased risk of mortality in MBC patients across the MBC-specific survival model (hazard ratio, 0.98; 95% confidence interval, 0.96-0.998; P = .03) and 10-year MBC-specific survival model (hazard ratio, 0.98; 95% confidence interval, 0.96-0.999; P = .04).

CONCLUSION

MBC has had an augmented incidence over the years. We found several independent predictors of MBC survival, including age, race, stage, NLNs, and the LNR. We strongly suggest adding the NLN count and/or LNR into the current staging system. Further studies are needed to provide information on the mechanisms underlying the association between the NLN count and MBC survival and the LNR and MBC survival.

How many ELNs are optimal for breast cancer patients with more than three PLNs who underwent MRM? A large population-based study

Background

Few studies have focused on the optimal threshold of examed lymph nodes (ELNs) for breast cancer patients with more than three positive lymph nodes after modified radical mastectomy.

Materials and methods

The X-tile and the minimum P-value models were applied to determine the optimal threshold. Cox proportional hazard analysis was used to analyze the cancer-specific survival and perform subgroup analysis.

Results

The results showed that 12 ELNs was the optimal threshold for these patients, and the patients with >12 ELNs had a better cancer-specific survival benefit compared with the patients with <12 ELNs (P<0.001).

Conclusion

The number 12 can be selected as the optimal threshold of ELNs for breast cancer patients with >3 positive lymph nodes after modified radical mastectomy.

The prognostic analysis of different metastatic patterns in extensive-stage small-cell lung cancer patients: a large population-based study

AIM

To analyze the metastasis patterns and prognosis differences for extensive-stage small-cell lung cancer patients.

METHODS

Log-rank tests were used to calculate and compare survival estimates. Cox regression analyses were used to evaluate the prognosis factors.

RESULTS

The liver was the most common metastatic site, and lung was the least common. In two metastatic sites, liver and bone metastases were the most common combination of sites. An isolated liver metastasis had the worst overall survival (OS) and cancer-specific survival (CSS) among metastatic sites (both p < 0.001). Liver and lung metastases were associated with worse CSS (p < 0.039) and OS (p < 0.015). However, for patients with three metastatic sites showed no statistical differences in their CSS and OS (all, p > 0.05).

CONCLUSION

Extensive-stage small-cell lung cancer patients with metastasis to the liver alone or in combination with other organs appear to have worse outcomes.