The value of the number of nodes removed (or the ratio of involved nodes) as a prognostic factor in breast cancer
Bibliographic record
Abstract
611 Background: To assess the prognostic value of the number of nodes removed and the ratio of positive nodes after breast conservative approach. Methods: A retrospective study including all breast cancer patients treated by conservative surgery between 1970 and 1997 at the Hotel-Dieu de Quebec. Kaplan-Meier and Cox multivariate analysis using known prognostic variables for distant metastases were performed in three groups: N0, N1–3 and N>3 positive nodes. Results: For the 1615 N0 patients, ten-year metastases free survival (10 year-MFS) was 75 % and 85% when <4 nodes and when ≥ 4 nodes were removed, p=0.0001. In a Cox model, the number of nodes removed (HR=0.64, p=0.002) ranks third after T stage (Hazard ratio:2.2, p<0.00) and age≥40 (HR=0.57, p=0.001). For the 919 N1–3 node positive patients, 10 year-MFS was 70 % and 61% when <8 nodes and when ≥ 8 nodes were removed, p=0.03. For the same group, 10 year-MFS were 70 % and 60% when the ratio of positive nodes was <0.25 and ≥0.25, p=0.0002. In a Cox model done on this group, ratio ranks third(after age and grade III) with a HR of 1.6, p=0.02. The number of positive nodes and the number of nodes removed were not independent prognostic factors. For the 444 N>3 node positive patients, 10 year-MFS was 47% and 46% when <10 nodes or ≥ 10 nodes were removed, p=0.5. For the same group, 10 year-MFS was 54%, 46 %, and 36% when ratio was <0.5, between 0.5–0.8 and ≥0.8, respectively, p=0.0009. In a Cox model done on this group, ratio is an independent prognostic factor(p=0.01) with T stage(p=0.01), number of positive nodes(p=0.01) and age(p=0.01). Compared to a ratio < 0.5, the HR of distant metastases was 1.26 and 1.5 when the ratio was 0.5–0.8 and ≥8, respectively. Conclusions: In N0 patients, the number of nodes removed (<4 vs. ≥4 ) is a prognostic factor. In N+ patients, ratio( <0.25 vs.≥0.25) for N1–3 and ratio (<0.5, 0.5–0.8 and ≥0.8) for N>3 positive nodes is an independent prognostic factor for distant metastases. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".