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Breast Cancer Recurrence in Initially Clinically Node-Positive Patients Undergoing Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy in the NEOSENTITURK-Trials MF18-02/18-03

  • 期刊论文

  • 发表日期：

    2024年12月2日

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  • Neslihan Cabioglu,
  • Hasan Karanlik,
  • Abdullah Igci,
  • Mahmut Muslumanoglu,
  • Mehmet Ali Gulcelik,
  • Cihan Uras,
  • Havva Belma Kocer,
  • Didem Can Trabulus,
  • Enver Ozkurt,
  • Guldeniz Karadeniz Cakmak,
  • Mustafa Tukenmez,
  • Suleyman Bademler,
  • Nilufer Yildirim,
  • Gökhan Giray Akgul,
  • Ebru Sen,
  • Kazim Senol,
  • Selman Emiroglu,
  • Bulent Citgez,
  • Yeliz Emine Ersoy,
  • Ahmet Dag,
  • Baha Zengel,
  • Gul Basaran,
  • Halil Kara,
  • Ece Dilege,
  • M. Umit Ugurlu,
  • Atilla Celik,
  • Serkan Ilgun,
  • Yasemin Bolukbasi,
  • Niyazi Karaman,
  • Gürhan Sakman,
  • Serdar Ozbas,
  • Halime Gul Kilic,
  • Ayfer Kamali Polat,
  • Ibrahim Ali Ozemir,
  • Berkay Kilic,
  • Ayse Altınok,
  • Ecenur Varol,
  • Lutfi Dogan,
  • Alper Akcan,
  • Beyza Ozcinar,
  • Leyla Zer,
  • Aykut Soyder,
  • Mehmet Velidedeoglu,
  • Fazilet Erozgen,
  • Berk Goktepe,
  • Mutlu Dogan,
  • Abut Kebudi,
  • Banu Yigit,
  • Burak Celik,
  • Serdar Yormaz,
  • Cumhur Arici,
  • Orhan Agcaoglu,
  • Ali Ibrahim Sevinc,
  • M. Kemal Atahan,
  • Vafa Valiyeva,
  • Elif Baran,
  • Israa Aljorani,
  • Zafer Utkan,
  • Levent Yeniay,
  • Taner Kivilcim,
  • Atilla Soran,
  • Adnan Aydiner,
  • Kamuran Ibis,
  • Vahit Ozmen

摘要

Background

This study aims to identify factors predicting recurrence and unfavorable prognosis in cN+ patients who have undergone sentinel lymph node biopsy (SLNB) following neoadjuvant chemotherapy (NAC).

Methods

The retrospective multi-centre “MF18-02” and the prospective multi-centre cohort registry trial “MF18-03” (NCT04250129) included patients with cT1-4N1-3M0 with SLNB+/− axillary lymph node dissection (ALND) post-NAC.

Results

A total of 2407 cN+ patients, who later achieved cN0 status after NAC and subsequently underwent SLNB, were studied. The majority had cT1-2 (79.1%) and N1 (80.7%). After a median follow-up time of 41 months, the rates of locoregional recurrence and axillary recurrence (AR) were 1.83% and 0.37%, respectively. No significant difference in locoregional recurrence or AR rates was observed between the SLNB/targeted axillary dissection-only (n = 1470) and ALND (n = 937) groups. Factors significantly linked with AR included age younger than 45 years, nonpathological complete response (non-pCR) in the breast, and nonluminal pathology. Locoregional recurrences were associated with nonluminal or HER2(+) pathology, non-pCR in the breast, and ALND. Poor prognostic factors for disease-free survival (DFS) included having cT3-T4, no breast pCR (non-pCR), ypN(+), and nonluminal pathology. No significant difference was found in DFS or disease-specific survival (DSS) rates among ypN0, ypN-isolated tumour cells, ypNmic, and ypN1. However, significant decreases in DFS and DSS rates were observed when comparing ypN2 or ypN3 disease with ypN0.

Conclusions

The present large registry data indicate that younger patients (<45), those with nonluminal pathology, and those who only partially respond in the breast are more susceptible to axillary and locoregional recurrences.