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Omission of axillary lymph node dissection in patients with ypN plus breast cancer after neoadjuvant chemotherapy: A retrospective multicenter study (KROG 21-06)
- Title
- Omission of axillary lymph node dissection in patients with ypN plus breast cancer after neoadjuvant chemotherapy: A retrospective multicenter study (KROG 21-06)
- Authors
- Park, Younghee; Shin, Young Seob; Kim, Kyubo; Shin, Kyung Hwan; Chang, Ji Hyun; Kim, Su Ssan; Jung, Jin Hong; Park, Won; Kim, Haeyoung; Kim, Yong Bae; Ahn, Sung Ja; Kim, Myungsoo; Kim, Jin Hee; Cha, Hye Jung; Kim, Tae Gyu; Park, Hae Jin; Lee, Sun Young
- Ewha Authors
- 김규보; 박영희
- SCOPUS Author ID
- 김규보; 박영희
- Issue Date
- 2023
- Journal Title
- EJSO
- ISSN
- 0748-7983
1532-2157
- Citation
- EJSO vol. 49, no. 3, pp. 589 - 596
- Keywords
- Breast cancer; Neoadjuvant chemotherapy; Residual nodal disease; Sentinel lymph node biopsy; Axillary lymph node dissection
- Publisher
- ELSEVIER SCI LTD
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: We evaluated the impact of omitting axillary lymph node dissection (ALND) on oncological outcomes in breast cancer patients with residual nodal disease after neoadjuvant chemotherapy (NAC). Methods: The medical records of patients who underwent NAC followed by surgical resection and had residual nodal disease were retrospectively reviewed. In total, 1273 patients from 12 institutions were included; all underwent postoperative radiotherapy. Axillary surgery consisted of ALND in 1103 patients (86.6%) and sentinel lymph node biopsy (SLNBx) alone in 170 (13.4%). Univariate and multivariate an-alyses of disease-free survival (DFS) and overall survival (OS) were performed before and after propensity score matching (PSM). Results: The median follow-up was 75.3 months (range, 2.5-182.7). Axillary recurrence rates were 4.8% in the ALND group (n = 53) and 4.7% in the SLNBx group (n = 8). Before PSM, univariate analysis indicated that the 5-year OS rate was inferior in the ALND group compared to the SLNBx group (86.6% vs. 93.3%, respectively; P = 0.002); multivariate analysis did not show a difference between groups (P = 0.325). After PSM, 258 and 136 patients were included in the ALND and SLNBx groups, respectively. There were no significant differences between the ALND and SLNBx groups in DFS (5-year rate, 75.8% vs. 76.9%, respectively; P = 0.406) or OS (5-year rate, 88.7% vs. 93.1%, respectively; P = 0.083). Conclusions: SLNBx alone did not compromise oncological outcomes in patients with residual nodal disease after NAC. The omission of ALND might be a possible option for axillary management in patients treated with NAC and postoperative radiotherapy.(c) 2022 Elsevier Ltd, BASO -The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
- DOI
- 10.1016/j.ejso.2022.11.099|http://dx.doi.org/10.1016/j.ejso.2022.11.099
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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