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Association of Axillary Dissection With Systemic Therapy in Patients With Clinically Node-Positive Breast Cancer.

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العنوان: Association of Axillary Dissection With Systemic Therapy in Patients With Clinically Node-Positive Breast Cancer.
المؤلفون: Weber, W.P., Matrai, Z., Hayoz, S., Tausch, C., Henke, G., Zimmermann, F., Montagna, G., Fitzal, F., Gnant, M., Ruhstaller, T., Muenst, S., Mueller, A., Lelièvre, L., Heil, J., Knauer, M., Egle, D., Sávolt, Á., Heidinger, M., Kurzeder, C., Zwahlen, D.R., Gruber, G., Ackerknecht, M., Kuemmel, S., Bjelic-Radisic, V., Smanykó, V., Vrieling, C., Satler, R., Hagen, D., Becciolini, C., Bucher, S., Simonson, C., Fehr, P.M., Gabriel, N., Maráz, R., Sarlos, D., Dedes, K.J., Leo, C., Berclaz, G., Fansa, H., Hager, C., Reisenberger, K., Singer, C.F., Loibl, S., Winkler, J., Lam, G.T., Fehr, M.K., Kohlik, M., Clerc, K., Ostapenko, V., Maggi, N., Schulz, A., Andreozzi, M., Goldschmidt, M., Saccilotto, R., Markellou, P.
المساهمون: TAXIS Study Writing Group
المصدر: JAMA surgery, vol. 158, no. 10, pp. 1013-1021
سنة النشر: 2023
المجموعة: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
مصطلحات موضوعية: Humans, Female, Middle Aged, Breast Neoplasms/drug therapy, Breast Neoplasms/surgery, Sentinel Lymph Node Biopsy, Lymphatic Metastasis/pathology, Cohort Studies, Prospective Studies, Lymph Node Excision, Lymph Nodes/pathology, Neoadjuvant Therapy, Axilla
الوصف: The role of axillary lymph node dissection (ALND) to determine nodal burden to inform systemic therapy recommendations in patients with clinically node (cN)-positive breast cancer (BC) is currently unknown. To address the association of ALND with systemic therapy in cN-positive BC in the upfront surgery setting and after neoadjuvant chemotherapy (NACT). This was a prospective, observational, cohort study conducted from August 2018 to June 2022. This was a preplanned study within the phase 3 randomized clinical OPBC-03/TAXIS trial. Included were patients with confirmed cN-positive BC from 44 private, public, and academic breast centers in 6 European countries. After NACT, residual nodal disease was mandatory, and a minimum follow-up of 2 months was required. All patients underwent tailored axillary surgery (TAS) followed by ALND or axillary radiotherapy (ART) according to TAXIS randomization. TAS removed suspicious palpable and sentinel nodes, whereas imaging-guidance was optional. Systemic therapy recommendations were at the discretion of the local investigators. A total of 500 patients (median [IQR] age, 57 [48-69] years; 487 female [97.4%]) were included in the study. In the upfront surgery setting, 296 of 335 patients (88.4%) had hormone receptor (HR)-positive and Erb-B2 receptor tyrosine kinase 2 (ERBB2; formerly HER2 or HER2/neu)-negative disease: 145 (49.0%) underwent ART, and 151 (51.0%) underwent ALND. The median (IQR) number of removed positive lymph nodes without ALND was 3 (1-4) nodes compared with 4 (2-9) nodes with ALND. There was no association of ALND with the proportion of patients undergoing adjuvant chemotherapy (81 of 145 [55.9%] vs 91 of 151 [60.3%]; adjusted odds ratio [aOR], 0.72; 95% CI, 0.19-2.67) and type of systemic therapy. Of 151 patients with NACT, 74 (51.0%) underwent ART, and 77 (49.0%) underwent ALND. The ratio of removed to positive nodes was a median (IQR) of 4 (3-7) nodes to 2 (1-3) nodes and 15 (12-19) nodes to 2 (1-5) nodes in the ART and ALND groups, respectively. There was ...
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/37466971; info:eu-repo/semantics/altIdentifier/eissn/2168-6262; info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_EB9EE331DB6B5; https://serval.unil.ch/notice/serval:BIB_EB9EE331DB6B; https://serval.unil.ch/resource/serval:BIB_EB9EE331DB6B.P001/REF.pdf
DOI: 10.1001/jamasurg.2023.2840
الاتاحة: https://serval.unil.ch/notice/serval:BIB_EB9EE331DB6B
https://doi.org/10.1001/jamasurg.2023.2840
https://serval.unil.ch/resource/serval:BIB_EB9EE331DB6B.P001/REF.pdf
http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_EB9EE331DB6B5
Rights: info:eu-repo/semantics/openAccess ; CC BY 4.0 ; https://creativecommons.org/licenses/by/4.0/
رقم الانضمام: edsbas.3779EF38
قاعدة البيانات: BASE
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