Predictive and prognostic value of total tumor load in sentinel lymph nodes in breast cancer patients after neoadjuvant treatment using one-step nucleic acid amplification : the NEOVATTL study
Vieites, B. (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
López-García, M. (Centro de Investigación Biomédica en Red de Cáncer)
Martín-Salvago, M.D. (Hospital Universitario Materno-Infantil (Jaen, Andalusia))
Ramírez Tortosa, César Luis (Hospital Universitario Materno-Infantil (Jaen, Andalusia))
Rezola, R. (Onkologikoa Kutxa Fundazioa)
Sancho, M. (Hospital Universitario de Salamanca)
López Vilaró, Laura (Institut d'Investigació Biomèdica Sant Pau)
Villardell, F. (Hospital Universitario Arnau de Vilanova)
Burgués, Octavio (Hospital Clínic Universitari (València))
Fernández-Rodriguez, B. (Complejo Hospitalario Universitario de Santiago de Compostela)
Alfaro, L. (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Peg, Vicente (Centro de Investigación Biomédica en Red de Cáncer)

Date:	2021
Abstract:	Objective: To evaluate the predictive and prognostic value of total tumor load (TTL) in sentinel lymph nodes (SLNs) in patients with infiltrating breast cancer after neoadjuvant systemic therapy (NST). Methods: This retrospective multicenter study used data from a Spanish Sentinel Lymph Node database. Patients underwent intraoperative SLN biopsy after NST. TTL was determined from whole nodes using a one-step nucleic acid amplification (OSNA) assay and defined as the total sum of CK19 mRNA copies in all positive SLNs. Cox-regression models identified independent predictive variables, which were incorporated into a nomogram to predict axillary non-SLN metastasis, and identified prognostic variables for incorporation into a disease-free survival (DFS) prognostic score. Results: A total of 314 patients were included; most had no lymph node involvement prior to NST (cN0; 75. 0% of patients). Most received chemotherapy with or without biologic therapy (91. 7%), and 81 patients had a pathologic complete response. TTL was predictive of non-SLN involvement (area under the concentration curve = 0. 87), and at a cut-off of 15,000 copies/µL had a negative predictive value of 90. 5%. Nomogram parameters included log (TTL + 1), maximum tumor diameter and study-defined NST response. TTL was prognostic of disease recurrence and DFS at a cut-off of 25,000 copies/µL. After a 5-year follow-up, DFS was higher in patients with ≤ 25,000 copies/µL than those with > 25,000 (89. 9% vs. 70. 0%; p = 0. 0017). Conclusions: TTL > 15,000 mRNA copies/µL was predictive of non-SLN involvement and TTL > 25,000 mRNA copies/µL was associated with a higher risk of disease recurrence in breast cancer patients who had received NST.
Note:	Altres ajuts: Sysmex España S.L.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Breast cancer ; Disease-free survival ; Neoadjuvant systemic therapy ; OSNA ; Sentinel lymph node ; Total tumor load
Published in:	Clinical & translational oncology, Vol. 23 Núm. 7 (july 2021) , p. 1377-1385, ISSN 1699-3055

DOI: 10.1007/s12094-020-02530-4
PMID: 33517542

9 p, 747.5 KB

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