{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:10:44Z","timestamp":1777349444598,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,2,28]],"date-time":"2013-02-28T00:00:00Z","timestamp":1362009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of the present study was to determine how lymph node ratio (LNR; the ratio of the number of metastatic lymph nodes to the number of removed lymph nodes) can supplement the TNM nodal classification in breast carcinoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed the file records of 2,151 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lymph node ratio\u2010based low\u2010 (LNR \u2264 0.20), intermediate\u2010 (LNR 0.21\u20130.65), and high\u2010risk (LNR &gt; 0.65) patient groups had significantly different disease\u2010free survival (DFS) (<jats:italic>P<\/jats:italic> &lt; 0.001). The DFS of patients with N1, N2, and N3 disease was significantly different (<jats:italic>P<\/jats:italic> &lt; 0.001). When LNR and TNM nodal groupings were included together in the Cox analysis, both groupings had independent prognostic significance (<jats:italic>P<\/jats:italic> &lt; 0.001 and <jats:italic>P<\/jats:italic> &lt; 0.001, respectively). The most significant LNR threshold value separating patients in low\u2010risk and high\u2010risk groups in terms of disease recurrence was 0.20 for N1 disease (<jats:italic>P<\/jats:italic> &lt; 0.001), 0.35 for N2 disease (<jats:italic>P<\/jats:italic> &lt; 0.001), and 0.90 for N3 disease (<jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lymph node ratio and TNM nodal groupings show no superiority over each other in categorizing patients with node\u2010positive breast carcinoma into prognostic groups of low\u2010, intermediate\u2010, and high\u2010risk. However, LNR grouping may supplement TNM nodal classification by categorizing patients within each TNM nodal group into low\u2010risk and high\u2010risk groups with significantly different survival.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-1965-1","type":"journal-article","created":{"date-parts":[[2013,2,27]],"date-time":"2013-02-27T15:28:59Z","timestamp":1361978939000},"page":"1241-1248","source":"Crossref","is-referenced-by-count":15,"title":["Lymph Node Ratio May Be Supplementary to TNM Nodal Classification in Node\u2010positive Breast Carcinoma Based on the Results of 2,151\u00a0Patients"],"prefix":"10.1002","volume":"37","author":[{"given":"N\u00fcvit","family":"Duraker","sequence":"first","affiliation":[{"name":"Third Department of Surgery SB Okmeydan\u0131 Training and Research Hospital Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bakir","family":"Bat\u0131","sequence":"additional","affiliation":[{"name":"Fifth Department of Surgery 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