Nodal Burden and Oncologic Outcomes in Patients With Residual Isolated Tumor Cells After Neoadjuvant Chemotherapy (ypN0i+): The OPBC-05/ICARO Study
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Le résumé fourni par la source
PURPOSE The nodal burden of patients with residual isolated tumor cells (ITCs) in the sentinel lymph nodes (SLNs) after neoadjuvant chemotherapy (NAC) (ypN0i+) is unknown, and axillary management is not standardized. We investigated rates of additional positive lymph nodes (LNs) at axillary lymph node dissection (ALND) and oncologic outcomes in patients with ypN0i+ treated with and without ALND. METHODS The Oncoplastic Breast Consortium-05/ICARO cohort study (ClinicalTrials.gov identifier: NCT06464341 ) retrospectively analyzed data from patients with stage I to III breast cancer with ITCs in SLNs after NAC from 62 centers in 18 countries. The primary end point was the 3-year rate of any axillary recurrence. The rate of any invasive recurrence was the secondary end point. RESULTS In total, 583 patients were included, of whom 182 (31%) had completion ALND and 401 (69%) did not. The median age was 48 years. Most patients (74%) were clinically node-positive at diagnosis and 41% had hormone receptor–positive/human epidermal growth factor receptor 2–negative tumors. The mean number of SLNs with ITCs was 1.2. Patients treated with ALND were more likely to present with cN2/3 disease (17% v 7%, P < .001), have ITCs detected on frozen section (62% v 8%, P < .001), have lymphovascular invasion (38% v 24%, P < .001), and receive adjuvant chest wall (89% v 78%, P = .024) and nodal radiation (82% v 75%, P = .038). Additional positive nodes were found at ALND in 30% of patients, but only 5% had macrometastases. The 3-year rates of any axillary and any invasive recurrence were 2% (95% CI, 0.95 to 3.6) and 11% (95% CI, 8 to 14), respectively, with no statistical difference by type of axillary surgery. CONCLUSION The nodal burden in patients with ypN0(i+) was low, and axillary recurrence after ALND omission was rare in patients selected for this approach. These results do not support routine ALND in all patients with ypN0(i+).
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Nodal Burden and Oncologic Outcomes in Patients With Residual Isolated Tumor Cells After Neoadjuvant Chemotherapy (ypN0i+): The OPBC-05/ICARO Study
- Date Crossref
- 01/03/2025
- Éditeur
- American Society of Clinical Oncology (ASCO)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Memorial Sloan Kettering Cancer Center pays non établi dans la noticeÉtablissement de santé
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Brigham and Women's Hospital Department of Surgery pays non établi dans la noticeÉtablissement de santé
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Istituto Oncologico Veneto pays non établi dans la noticeÉtablissement de santé
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Mayo Clinic in Arizona Department of Surgery pays non établi dans la noticeÉtablissement de santé
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The University of Texas MD Anderson Cancer Center Department of Breast Surgical Oncology pays non établi dans la noticeÉtablissement de santé
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Istanbul University Institute of Oncology pays non établi dans la noticeUniversité ou école supérieure
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Zonguldak Bülent Ecevit University pays non établi dans la noticeUniversité ou école supérieure
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Tel Aviv University pays non établi dans la noticeUniversité ou école supérieure
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Sheba Medical Center pays non établi dans la noticeÉtablissement de santé
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University Hospital Schleswig-Holstein pays non établi dans la noticeÉtablissement de santé
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University of Lübeck pays non établi dans la noticeUniversité ou école supérieure
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Cambridge University Hospitals NHS Foundation Trust pays non établi dans la noticeOrganisme public
Memorial Sloan Kettering Cancer Center, Department of Surgery — Brigham and Women's Hospital et Istituto Oncologico Veneto, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.