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
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 n...
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| Veröffentlicht in: | Cancers 2022-01, Vol.14 (3), p.521 |
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| creator | Gerber, Bernd Schneeweiss, Andreas Möbus, Volker Golatta, Michael Tesch, Hans Krug, David Hanusch, Claus Denkert, Carsten Lübbe, Kristina Heil, Jörg Huober, Jens Ataseven, Beyhan Klare, Peter Hahn, Markus Untch, Michael Kast, Karin Jackisch, Christian Thomalla, Jörg Seither, Fenja Blohmer, Jens-Uwe Rhiem, Kerstin Fasching, Peter A Nekljudova, Valentina Loibl, Sibylle Kühn, Thorsten |
| description | 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).
Retrospective, exploratory analysis of 242 patients with pN+ at diagnosis from the multicentric, randomized GeparOcto trial.
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;
= 0.0028 for iDFS) was the strongest independent prognostic factor.
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. |
| doi_str_mv | 10.3390/cancers14030521 |
| format | Article |
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Retrospective, exploratory analysis of 242 patients with pN+ at diagnosis from the multicentric, randomized GeparOcto trial.
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;
= 0.0028 for iDFS) was the strongest independent prognostic factor.
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.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers14030521</identifier><identifier>PMID: 35158789</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Biopsy ; Breast cancer ; ErbB-2 protein ; Invasiveness ; Lymph nodes ; Lymphatic system ; Mammography ; Medical prognosis ; Metastasis ; Patients ; Prognosis ; Surgeons ; Surgery ; Survival ; Ultrasonic imaging</subject><ispartof>Cancers, 2022-01, Vol.14 (3), p.521</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c421t-15ed4cbbc7e9e9f353db2b2e7302464329e42718c1be6b20ec48915c8bed19333</citedby><cites>FETCH-LOGICAL-c421t-15ed4cbbc7e9e9f353db2b2e7302464329e42718c1be6b20ec48915c8bed19333</cites><orcidid>0000-0002-9669-5657 ; 0000-0002-7969-250X ; 0000-0002-2823-7590 ; 0000-0002-2605-0060 ; 0000-0003-4885-8471 ; 0000-0002-8708-2824 ; 0000-0002-8550-1407</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833390/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833390/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35158789$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gerber, Bernd</creatorcontrib><creatorcontrib>Schneeweiss, Andreas</creatorcontrib><creatorcontrib>Möbus, Volker</creatorcontrib><creatorcontrib>Golatta, Michael</creatorcontrib><creatorcontrib>Tesch, Hans</creatorcontrib><creatorcontrib>Krug, David</creatorcontrib><creatorcontrib>Hanusch, Claus</creatorcontrib><creatorcontrib>Denkert, Carsten</creatorcontrib><creatorcontrib>Lübbe, Kristina</creatorcontrib><creatorcontrib>Heil, Jörg</creatorcontrib><creatorcontrib>Huober, Jens</creatorcontrib><creatorcontrib>Ataseven, Beyhan</creatorcontrib><creatorcontrib>Klare, Peter</creatorcontrib><creatorcontrib>Hahn, Markus</creatorcontrib><creatorcontrib>Untch, Michael</creatorcontrib><creatorcontrib>Kast, Karin</creatorcontrib><creatorcontrib>Jackisch, Christian</creatorcontrib><creatorcontrib>Thomalla, Jörg</creatorcontrib><creatorcontrib>Seither, Fenja</creatorcontrib><creatorcontrib>Blohmer, Jens-Uwe</creatorcontrib><creatorcontrib>Rhiem, Kerstin</creatorcontrib><creatorcontrib>Fasching, Peter A</creatorcontrib><creatorcontrib>Nekljudova, Valentina</creatorcontrib><creatorcontrib>Loibl, Sibylle</creatorcontrib><creatorcontrib>Kühn, Thorsten</creatorcontrib><title>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</title><title>Cancers</title><addtitle>Cancers (Basel)</addtitle><description>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).
Retrospective, exploratory analysis of 242 patients with pN+ at diagnosis from the multicentric, randomized GeparOcto trial.
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;
= 0.0028 for iDFS) was the strongest independent prognostic factor.
In initially pN+ patients undergoing NAST, the conversion to ypN0 is of high prognostic value. 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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</title><author>Gerber, Bernd ; Schneeweiss, Andreas ; Möbus, Volker ; Golatta, Michael ; Tesch, Hans ; Krug, David ; Hanusch, Claus ; Denkert, Carsten ; Lübbe, Kristina ; Heil, Jörg ; Huober, Jens ; Ataseven, Beyhan ; Klare, Peter ; Hahn, Markus ; Untch, Michael ; Kast, Karin ; Jackisch, Christian ; Thomalla, Jörg ; Seither, Fenja ; Blohmer, Jens-Uwe ; Rhiem, Kerstin ; Fasching, Peter A ; Nekljudova, Valentina ; Loibl, Sibylle ; Kühn, Thorsten</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c421t-15ed4cbbc7e9e9f353db2b2e7302464329e42718c1be6b20ec48915c8bed19333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Biopsy</topic><topic>Breast cancer</topic><topic>ErbB-2 protein</topic><topic>Invasiveness</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Mammography</topic><topic>Medical prognosis</topic><topic>Metastasis</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Survival</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gerber, Bernd</creatorcontrib><creatorcontrib>Schneeweiss, Andreas</creatorcontrib><creatorcontrib>Möbus, Volker</creatorcontrib><creatorcontrib>Golatta, Michael</creatorcontrib><creatorcontrib>Tesch, Hans</creatorcontrib><creatorcontrib>Krug, David</creatorcontrib><creatorcontrib>Hanusch, Claus</creatorcontrib><creatorcontrib>Denkert, Carsten</creatorcontrib><creatorcontrib>Lübbe, Kristina</creatorcontrib><creatorcontrib>Heil, Jörg</creatorcontrib><creatorcontrib>Huober, Jens</creatorcontrib><creatorcontrib>Ataseven, 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Michael</au><au>Kast, Karin</au><au>Jackisch, Christian</au><au>Thomalla, Jörg</au><au>Seither, Fenja</au><au>Blohmer, Jens-Uwe</au><au>Rhiem, Kerstin</au><au>Fasching, Peter A</au><au>Nekljudova, Valentina</au><au>Loibl, Sibylle</au><au>Kühn, Thorsten</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Cancers</jtitle><addtitle>Cancers (Basel)</addtitle><date>2022-01-20</date><risdate>2022</risdate><volume>14</volume><issue>3</issue><spage>521</spage><pages>521-</pages><issn>2072-6694</issn><eissn>2072-6694</eissn><abstract>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).
Retrospective, exploratory analysis of 242 patients with pN+ at diagnosis from the multicentric, randomized GeparOcto trial.
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;
= 0.0028 for iDFS) was the strongest independent prognostic factor.
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.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>35158789</pmid><doi>10.3390/cancers14030521</doi><orcidid>https://orcid.org/0000-0002-9669-5657</orcidid><orcidid>https://orcid.org/0000-0002-7969-250X</orcidid><orcidid>https://orcid.org/0000-0002-2823-7590</orcidid><orcidid>https://orcid.org/0000-0002-2605-0060</orcidid><orcidid>https://orcid.org/0000-0003-4885-8471</orcidid><orcidid>https://orcid.org/0000-0002-8708-2824</orcidid><orcidid>https://orcid.org/0000-0002-8550-1407</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2072-6694 |
| ispartof | Cancers, 2022-01, Vol.14 (3), p.521 |
| issn | 2072-6694 2072-6694 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8833390 |
| source | MDPI - Multidisciplinary Digital Publishing Institute; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Biopsy Breast cancer ErbB-2 protein Invasiveness Lymph nodes Lymphatic system Mammography Medical prognosis Metastasis Patients Prognosis Surgeons Surgery Survival Ultrasonic imaging |
| title | 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 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-13T08%3A41%3A30IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Pathological%20Response%20in%20the%20Breast%20and%20Axillary%20Lymph%20Nodes%20after%20Neoadjuvant%20Systemic%20Treatment%20in%20Patients%20with%20Initially%20Node-Positive%20Breast%20Cancer%20Correlates%20with%20Disease%20Free%20Survival:%20An%20Exploratory%20Analysis%20of%20the%20GeparOcto%20Trial&rft.jtitle=Cancers&rft.au=Gerber,%20Bernd&rft.date=2022-01-20&rft.volume=14&rft.issue=3&rft.spage=521&rft.pages=521-&rft.issn=2072-6694&rft.eissn=2072-6694&rft_id=info:doi/10.3390/cancers14030521&rft_dat=%3Cproquest_pubme%3E2629058580%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2627539507&rft_id=info:pmid/35158789&rfr_iscdi=true |