Cover Image

Pathological response in the breast and axillary lymph nodes after neoadjuvant systemic treatment in patients with initially node-positive breast cancer correlates with disease free survival: an exploratory analysis of the GeparOcto trial

Background: The conversion of initially histologically confirmed axillary lymph node-positive (pN+) to ypN0 after neoadjuvant systemic treatment (NAST) is an important prognostic factor in breast cancer (BC) patients and may influence surgical de-escalation strategies. We aimed to determine pCR rate...

Full description

Saved in:
Bibliographic Details
Main Authors: Gerber, Bernd (Author) , Schneeweiss, Andreas (Author) , Möbus, Volker (Author) , Golatta, Michael (Author) , Tesch, Hans (Author) , Krug, David (Author) , Hanusch, Claus Alexander (Author) , Denkert, Carsten (Author) , Lübbe, Kristina (Author) , Heil, Jörg (Author) , Huober, Jens (Author) , Ataseven, Beyhan (Author) , Klare, Peter (Author) , Hahn, Markus (Author) , Untch, Michael (Author) , Kast, Karin (Author) , Jackisch, Christian (Author) , Thomalla, Jörg (Author) , Seither, Fenja (Author) , Blohmer, Jens-Uwe (Author) , Rhiem, Kerstin E. M. (Author) , Fasching, Peter Andreas (Author) , Nekljudova, Valentina (Author) , Loibl, Sibylle (Author) , Kühn, Thorsten (Author)
Format: Article (Journal)
Language:English
Published: 20 January 2022
In: Cancers
Year: 2022, Volume: 14, Issue: 3, Pages: 1-12
ISSN:2072-6694
DOI:10.3390/cancers14030521
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/cancers14030521
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2072-6694/14/3/521
Get full text
Author Notes:Bernd Gerber, Andreas Schneeweiss, Volker Möbus, Michael Golatta, Hans Tesch, David Krug, Claus Hanusch, Carsten Denkert, Kristina Lübbe, Jörg Heil, Jens Huober, Beyhan Ataseven, Peter Klare, Markus Hahn, Michael Untch, Karin Kast, Christian Jackisch, Jörg Thomalla, Fenja Seither, Jens-Uwe Blohmer, Kerstin Rhiem, Peter A. Fasching, Valentina Nekljudova, Sibylle Loibl and Thorsten Kühn
Description
Summary:Background: The conversion of initially histologically confirmed axillary lymph node-positive (pN+) to ypN0 after neoadjuvant systemic treatment (NAST) is an important prognostic factor in breast cancer (BC) patients and may influence surgical de-escalation strategies. We aimed to determine pCR rates in lymph nodes (pCR-LN), the breast (pCR-B), and both (tpCR) in women who present with pN+ BC, to assess predictors for response and the impact of pCR-LN, pCR-B, and tpCR on invasive disease-free survival (iDFS). Methods: Retrospective, exploratory analysis of 242 patients with pN+ at diagnosis from the multicentric, randomized GeparOcto trial. Results: Of 242 patients with initially pN+ disease, 134 (55.4%) had a pCR-LN, and 109 (45.0%) a pCR-B. Of the 109 pCR-B patients, 9 (8.3%) patients had involved LN, and 100 (41.3%) patients had tpCR. Those with involved LN still had a bad prognosis. As expected, pCR-B and intrinsic subtypes (TNBC and HER2+) were identified as independent predictors of pCR-LN. pCR-LN (ypN0; hazard ratio 0.42; 95%, CI 0.23-0.75; p = 0.0028 for iDFS) was the strongest independent prognostic factor. Conclusions: In initially pN+ patients undergoing NAST, the conversion to ypN0 is of high prognostic value. Surgical axillary staging after NAST is still essential in these patients to offer tailored treatment.
Item Description:Gesehen am 25.03.2022
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers14030521

Similar Items