Abstract
Background: Given the lack of established indications for elective nodal irradiation (ENI) in ypN0 patients after neoadjuvant chemotherapy (NAC) and breast-conserving surgery (BCS), we set out to investigate the role of ENI in ypN0 patients according to subtype and pathologic complete remission (pCR) status. Patients and Methods: We analyzed 261 patients who received NAC followed by BCS and adjuvant radiotherapy in 13 institutions of the Korean Radiation Oncology Group from 2005 to 2011. The tumors were classified into one of 3 subtypes: luminal (estrogen receptor positive or progesterone receptor positive and HER2 negative), HER2 (HER2 positive), or triple negative (estrogen receptor, progesterone receptor, and HER2 negative). We compared locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) according to ENI in different subgroups generated by the subtype and pCR statuses. Results: In all patients, the 5-year LRC, DFS, and OS rates were 96.0%, 91.0%, and 96.8%, respectively. In all patients, axillary lymph node dissection was found to be the only favorable factor for LRC (P =.023) and DFS (P =.001). Age ≥ 50 years (P =.027), negative resection margin (P =.002), and axillary lymph node dissection (P =.002) were all favorable factors for OS. ENI did not affect LRC, DFS, or OS. Subgroup analysis by tumor subtype and pCR showed that ENI was not associated with greater LRC or DFS in any subgroups. Conclusion: In ypN0 patients after NAC and BCS, ENI did not improve LRC or survival, regardless of subtype or primary tumor response. This result should be verified through larger prospective trials.
| Original language | English |
|---|---|
| Pages (from-to) | 78-86 |
| Number of pages | 9 |
| Journal | Clinical Breast Cancer |
| Volume | 19 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2019 Feb |
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All Science Journal Classification (ASJC) codes
- Oncology
- Cancer Research
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Role of Elective Nodal Irradiation in Patients With ypN0 After Neoadjuvant Chemotherapy Followed by Breast-Conserving Surgery (KROG 16-16). / Cho, Won Kyung; Park, Won; Choi, Doo Ho; Kim, Yong Bae; Kim, Jin Ho; Kim, Su Ssan; Kim, Kyubo; Kim, Jin Hee; Ahn, Sung Ja; Lee, Sun Young; Lee, Jeongshim; Kim, Sang Won; Kwon, Jeanny; Ahn, Ki Jung.
In: Clinical Breast Cancer, Vol. 19, No. 1, 02.2019, p. 78-86.Research output: Contribution to journal › Article
TY - JOUR
T1 - Role of Elective Nodal Irradiation in Patients With ypN0 After Neoadjuvant Chemotherapy Followed by Breast-Conserving Surgery (KROG 16-16)
AU - Cho, Won Kyung
AU - Park, Won
AU - Choi, Doo Ho
AU - Kim, Yong Bae
AU - Kim, Jin Ho
AU - Kim, Su Ssan
AU - Kim, Kyubo
AU - Kim, Jin Hee
AU - Ahn, Sung Ja
AU - Lee, Sun Young
AU - Lee, Jeongshim
AU - Kim, Sang Won
AU - Kwon, Jeanny
AU - Ahn, Ki Jung
PY - 2019/2
Y1 - 2019/2
N2 - Background: Given the lack of established indications for elective nodal irradiation (ENI) in ypN0 patients after neoadjuvant chemotherapy (NAC) and breast-conserving surgery (BCS), we set out to investigate the role of ENI in ypN0 patients according to subtype and pathologic complete remission (pCR) status. Patients and Methods: We analyzed 261 patients who received NAC followed by BCS and adjuvant radiotherapy in 13 institutions of the Korean Radiation Oncology Group from 2005 to 2011. The tumors were classified into one of 3 subtypes: luminal (estrogen receptor positive or progesterone receptor positive and HER2 negative), HER2 (HER2 positive), or triple negative (estrogen receptor, progesterone receptor, and HER2 negative). We compared locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) according to ENI in different subgroups generated by the subtype and pCR statuses. Results: In all patients, the 5-year LRC, DFS, and OS rates were 96.0%, 91.0%, and 96.8%, respectively. In all patients, axillary lymph node dissection was found to be the only favorable factor for LRC (P =.023) and DFS (P =.001). Age ≥ 50 years (P =.027), negative resection margin (P =.002), and axillary lymph node dissection (P =.002) were all favorable factors for OS. ENI did not affect LRC, DFS, or OS. Subgroup analysis by tumor subtype and pCR showed that ENI was not associated with greater LRC or DFS in any subgroups. Conclusion: In ypN0 patients after NAC and BCS, ENI did not improve LRC or survival, regardless of subtype or primary tumor response. This result should be verified through larger prospective trials.
AB - Background: Given the lack of established indications for elective nodal irradiation (ENI) in ypN0 patients after neoadjuvant chemotherapy (NAC) and breast-conserving surgery (BCS), we set out to investigate the role of ENI in ypN0 patients according to subtype and pathologic complete remission (pCR) status. Patients and Methods: We analyzed 261 patients who received NAC followed by BCS and adjuvant radiotherapy in 13 institutions of the Korean Radiation Oncology Group from 2005 to 2011. The tumors were classified into one of 3 subtypes: luminal (estrogen receptor positive or progesterone receptor positive and HER2 negative), HER2 (HER2 positive), or triple negative (estrogen receptor, progesterone receptor, and HER2 negative). We compared locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) according to ENI in different subgroups generated by the subtype and pCR statuses. Results: In all patients, the 5-year LRC, DFS, and OS rates were 96.0%, 91.0%, and 96.8%, respectively. In all patients, axillary lymph node dissection was found to be the only favorable factor for LRC (P =.023) and DFS (P =.001). Age ≥ 50 years (P =.027), negative resection margin (P =.002), and axillary lymph node dissection (P =.002) were all favorable factors for OS. ENI did not affect LRC, DFS, or OS. Subgroup analysis by tumor subtype and pCR showed that ENI was not associated with greater LRC or DFS in any subgroups. Conclusion: In ypN0 patients after NAC and BCS, ENI did not improve LRC or survival, regardless of subtype or primary tumor response. This result should be verified through larger prospective trials.
UR - http://www.scopus.com/inward/record.url?scp=85053722564&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053722564&partnerID=8YFLogxK
U2 - 10.1016/j.clbc.2018.08.009
DO - 10.1016/j.clbc.2018.08.009
M3 - Article
C2 - 30241965
AN - SCOPUS:85053722564
VL - 19
SP - 78
EP - 86
JO - Clinical Breast Cancer
JF - Clinical Breast Cancer
SN - 1526-8209
IS - 1
ER -