Prognostic value of isolated tumour cells in sentinel lymph nodes in early-stage breast cancer: a prospective study.

Autor: Liikanen JS; Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital and University of Helsinki, P.O. Box 263, FIN-00029 HUS, Helsinki, Finland. jenni.liikanen@helsinki.fi., Leidenius MH; Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital and University of Helsinki, P.O. Box 263, FIN-00029 HUS, Helsinki, Finland., Joensuu H; Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, P.O. Box 180, FIN-00029 HUS, Helsinki, Finland., Vironen JH; Abdominal Center, Helsinki University Hospital and University of Helsinki, P.O. Box 340, FIN-00029 HUS, Helsinki, Finland., Meretoja TJ; Comprehensive Cancer Center, Breast Surgery Unit, Helsinki University Hospital and University of Helsinki, P.O. Box 263, FIN-00029 HUS, Helsinki, Finland.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2018 May; Vol. 118 (11), pp. 1529-1535. Date of Electronic Publication: 2018 Apr 24.
DOI: 10.1038/s41416-018-0052-7
Abstrakt: Background: The prognostic significance of isolated tumour cells (ITCs) in the sentinel nodes (SNs) is controversial in early breast cancer, and some centres have abandoned immunohistochemistry to detect ITCs.
Methods: Patients with unilateral pT1N0 breast cancer, operated between February 2001 and August 2005 at a university hospital were included in this prospective, population-based cohort study. Survival of 936 patients with or without isolated tumour cells (ITC) in their SNs were compared with the log-rank test and Cox regression analysis.
Results: Eight hundred sixty one (92.0%) patients were ITC-negative (pN0i-) and 75 (8.0%) ITC-positive (pN0i+). Patients with ITC-positive cancer received more frequently adjuvant systemic therapies than those with ITC-negative cancer. The median follow-up time was 9.5 years. Ten-year distant disease-free survival was 95.3% in the pN0i- group and 88.8% in the pN0i+ group (P = 0.013). ITCs were an independent prognostic factor in a Cox regression model (HR = 2.34, 95% CI 1.09-5.04; P = 0.029), together with tumour Ki-67 proliferation index and diameter. ITCs were associated with unfavourable overall survival (P = 0.005) and breast cancer-specific survival (P = 0.001).
Conclusions: We conclude that presence of ITCs in the SNs is an adverse prognostic factor in early small node-negative breast cancer, and may be considered in the decision-making for adjuvant therapy.
Databáze: MEDLINE
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