Lymph node ratio and breast cancer prognosis: a meta-analysis

Due to the heterogeneity of lymph node examination and the conflicting results existing for the same classification of lymph node ratio (LNR), it is necessary to conduct a meta-analysis to evaluate the prognostic effects of different LNRs on breast cancer. PubMed, EMBASE, and ISI Web of Knowledge were searched to find all published cohort studies that evaluated the prognostic value of different LNRs on breast cancer. The outcomes were overall survival (OS), disease-free survival (DFS), breast cause-special survival (BCCS), mortality, locoregional recurrence (LRR), and distant metastasis. Data was analyzed using comprehensive meta-analysis software version 2.0, and 23 studies were included. The available evidence showed that LNR was a prognostic predictor for breast cancer, especially for clinically node-positive breast cancer, but the available evidence could not judge which cutoff point is the most reliable. Meanwhile, the cutoff values 0.2 and 0.65 could be suitable to predict breast cancer OS, DFS, BCCS, and mortality.