Feifei Zhou

Lymph Node Ratio and pN Staging Show Different Superiority As Prognostic Predictors Depending on the Number of Lymph Nodes Dissected in Chinese Patients With Luminal A Breast Cancer

BACKGROUND The lymph node ratio (LNR) classification has shown superiority to pN staging (the number of positive lymph nodes) in breast cancers, but it has not been examined according to whether sufficient lymph nodes have been dissected. METHODS All Chinese patients with luminal A breast cancer with positive lymph nodes seen at Sun Yat-sen University Cancer Center between 1995 and 2009 were enrolled. Disease-free survival (DFS) and overall survival (OS) were the endpoints, and the patients were further classified into 2 groups according to whether ≤ 10 or > 10 lymph nodes were dissected. RESULTS For the whole group, the OS curves of the pN stages overlapped, whereas they were separated in the LNR survival curves. LNR was an independent prognostic factor for OS and DFS, whereas the pN stage was not. In the ≤ 10 lymph nodes dissected group, both OS and DFS curves were clearly separated in the pN staging but overlapped in the LNR classification. In the > 10 lymph nodes dissected group, LNR showed no overlap in the OS curves and was an independent prognostic factor of OS and DFS when compared with pN staging. CONCLUSION In Chinese patients with luminal A breast cancer, LNR classification and the pN stage show different superiority as prognostic predictors according to whether > 10 or < 10 lymph nodes are dissected.

A Potential Administration-time Dependent Effect of Bevacizumab inImproving Overall Survival and Increasing Metastasis in MetastaticColorectal Cancer

Background: The effectiveness of Bevacizumab has been demonstrated for the treatment of metastatic colorectal cancer. However, the minimum number of bevacizumab cycles needed to improve overall survival is unknown. In addition, anti-angiogenic treatment has been shown in preclinical studies to accelerate metastasis. To investigate these two issues, we performed a retrospective case-control study in Chinese patients with metastatic colorectal cancer. Methods: Patients initially diagnosed as metastatic colorectal cancer at the Sun Yat-sen University Cancer Center from 2004 to 2010 were recruited. All patients treated with bevacizumab served as experimental group; patients not treated with bevacizumab were control group. The primary endpoints were overall survival and the incidence of new metastatic lesions in the liver and other organs. Results: Patients received more than 4 cycles of bevacizumab showed a significantly prolonged overall survival than patients in the control group. The median overall survival was 31.53 months (95% CI, 23.22-39.85 months) and 19.70 months (95% CI, 16.61-22.79 months; P=0.031) for the experimental and control groups, respectively. The patients receiving bevacizumab more than 3 times showed an increased risk compared to the patients in control group of developing new metastatic lesions in the liver (17/23 versus 25/55, respectively, P=0.022) and other organs (14/23 versus 19/55, respectively, P=0.032). Conclusion: More than 4 doses of bevacizumab were required to improve overall survival in metastatic colorectal cancer; a potentially accelerated metastasis rate was observed after more than 3 doses of bevacizumab. However, studies with larger patient sample sizes are urgently needed to validate our findings.