Prognostic Value of Lymph Node Micrometastases in Breast Cancer: A Multicenter Cohort Study
| Autor: | V. Bongers, Marike C. Kokke, Frits van den Wildenberg, Bob van Wely, Sjoerd G. Elias, Thijs van Dalen, Miranda F. Ernst, Inne H.M. Borel Rinkes, E. B. M. Theunissen, Joost van Gorp, J. H. Wijsman, Paul D. Gobardhan, Carmen C. van der Pol, Eva V. E. Madsen |
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| Jazyk: | angličtina |
| Předmět: |
Oncology
Adult medicine.medical_specialty Lymphatic metastasis Breast Neoplasms Breast Oncology Cohort Studies Breast cancer Surgical oncology Internal medicine medicine Humans Neoplasm Invasiveness skin and connective tissue diseases Lymph node Survival rate Aged Neoplasm Staging Aged 80 and over business.industry Sentinel Lymph Node Biopsy Follow up studies Middle Aged medicine.disease Survival Rate medicine.anatomical_structure Treatment Outcome Lymphatic Metastasis Neoplasm staging Female Surgery Lymph Nodes Neoplasm Recurrence Local business Cohort study Follow-Up Studies |
| Zdroj: | Annals of Surgical Oncology |
| ISSN: | 1068-9265 |
| DOI: | 10.1245/s10434-010-1451-z |
| Popis: | Background To evaluate the prognostic meaning of lymph node micrometastases in breast cancer patients. Methods Between January 2000 and January 2003, 1411 patients with a cT1-2N0 invasive breast carcinoma underwent surgery in 7 hospitals in the Netherlands. Sentinel lymph node biopsy was done in all patients. Based on lymph node status, patients were divided into 4 groups: pN0 (n = 922), pN1micro (n = 103), pN1a (n = 285), and pN≥1b (n = 101). Median follow-up was 6.4 years. Results At the end of follow-up, 1121 women were still alive (79.4%), 184 had died (13.0%), and 106 were lost to follow-up (7.5%). Breast cancer recurred in 244 patients: distant metastasis (n = 165), locoregional relapse (n = 83), and contralateral breast cancer (n = 44). Following adjustment for possible confounding characteristics and for adjuvant systemic treatment, overall survival (OS) remained comparable for pN0 and pN1micro and was significantly worse for pN1a and pN≥1b (hazard ratio [HR] 1.18; 95% confidence interval [95% CI] 0.58–2.39, HR 2.47; 95% CI 1.69–3.63, HR 4.36; 95% CI 2.70–7.04, respectively). Disease-free survival (DFS) was similar too in the pN0 and pN1micro group, and worse for pN1a and pN≥1b (HR 0.96; 95% CI 0.56–1.67 vs HR 1.64; 95% CI 1.19–2.27, HR 2.95; CI 1.98–4.42). The distant metastases rate also did not differ significantly between the pN0 and pN1micro group and was worse for pN1a and pN≥1b (HR 1.22; 95% CI 0.60–2.49, HR 2.26; 95% CI 1.49–3.40, HR 3.49; CI 2.12–5.77). Conclusions In breast cancer patients survival is not affected by the presence of micrometastatic lymph node involvement. Electronic supplementary material The online version of this article (doi:10.1245/s10434-010-1451-z) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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