The impact of postmastectomy radiotherapy on cT1-2N1 breast cancer patients with ypN0 after neoadjuvant chemotherapy: a retrospective study based on real-world data
Abstract Background The role of postmastectomy radiation therapy (PMRT) in clinical T1-2N1 breast cancer patients who achieve axillary pathological complete response (ypN0) after neoadjuvant chemotherapy (NAC) is controversial. Methods Data from cT1-2N1 breast cancer patients who converted to ypN0 a...
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| Format: | Article |
| Language: | English |
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Springer
2023-01-01
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| Series: | Discover Oncology |
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| Online Access: | https://doi.org/10.1007/s12672-022-00609-8 |
| _version_ | 1797958596889149440 |
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| author | Yuran Dai Shishi Ma Ailin Lan Yihua Wang Yu Wang Yudi Jin Nan Ding Linshan Jiang Zhenrong Tang Xuedong Yin Yang Peng Shengchun Liu |
| author_facet | Yuran Dai Shishi Ma Ailin Lan Yihua Wang Yu Wang Yudi Jin Nan Ding Linshan Jiang Zhenrong Tang Xuedong Yin Yang Peng Shengchun Liu |
| author_sort | Yuran Dai |
| collection | DOAJ |
| description | Abstract Background The role of postmastectomy radiation therapy (PMRT) in clinical T1-2N1 breast cancer patients who achieve axillary pathological complete response (ypN0) after neoadjuvant chemotherapy (NAC) is controversial. Methods Data from cT1-2N1 breast cancer patients who converted to ypN0 after NAC and subsequent surgery were retrospectively analyzed. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan‒Meier method. Univariate and multivariate Cox regression models were applied to investigate the correlations between clinical or pathological parameters and survival. Results From 2012–2019, we identified 116 cases for analysis, including 31 (26.7%) who received PMRT and 85 (73.3%) who did not. At a median follow-up time of 56.4 months, the 5-year DFS and OS rates were 90.2% and 96.7% with PMRT and 93.7% and 97.3% without PMRT, respectively. PMRT did not affect either DFS (p = 0.234) or OS (p = 0.878). On multivariate analyses, no differences in DFS or OS between the two groups were detected, taking into consideration the following factors: age, molecular subtype, Ki67 index, cT stage, and in-breast pathologic complete response (DFS: HR 2.260; 95% CI 0.465–10.982; p = 0.312. OS: HR 1.400; 95% CI 0.138–14.202; p = 0.776). This nonsignificant difference was also consistent in subgroup analyses (all p > 0.05). Conclusions PMRT has limited ability to confer DFS or OS benefits for cT1-2N1 breast cancer patients who achieved axillary pathological complete response after NAC and total mastectomy. It is imperative to conduct prospective studies to investigate the safety and feasibility of omitting PMRT. Trial registration: This research was approved by the Ethics Committee of The First Affiliated Hospital of Chongqing Medical University (ID: No. 2021–442). |
| first_indexed | 2024-04-11T00:22:17Z |
| format | Article |
| id | doaj.art-c36c2341b2af4cc1a3fbf46fbfb37edc |
| institution | Directory Open Access Journal |
| issn | 2730-6011 |
| language | English |
| last_indexed | 2024-04-11T00:22:17Z |
| publishDate | 2023-01-01 |
| publisher | Springer |
| record_format | Article |
| series | Discover Oncology |
| spelling | doaj.art-c36c2341b2af4cc1a3fbf46fbfb37edc2023-01-08T12:15:09ZengSpringerDiscover Oncology2730-60112023-01-0114111110.1007/s12672-022-00609-8The impact of postmastectomy radiotherapy on cT1-2N1 breast cancer patients with ypN0 after neoadjuvant chemotherapy: a retrospective study based on real-world dataYuran Dai0Shishi Ma1Ailin Lan2Yihua Wang3Yu Wang4Yudi Jin5Nan Ding6Linshan Jiang7Zhenrong Tang8Xuedong Yin9Yang Peng10Shengchun Liu11Department of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Oncology, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Pathology, Chongqing University Cancer HospitalDepartment of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical UniversityDepartment of Breast and Thyroid Surgery, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background The role of postmastectomy radiation therapy (PMRT) in clinical T1-2N1 breast cancer patients who achieve axillary pathological complete response (ypN0) after neoadjuvant chemotherapy (NAC) is controversial. Methods Data from cT1-2N1 breast cancer patients who converted to ypN0 after NAC and subsequent surgery were retrospectively analyzed. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan‒Meier method. Univariate and multivariate Cox regression models were applied to investigate the correlations between clinical or pathological parameters and survival. Results From 2012–2019, we identified 116 cases for analysis, including 31 (26.7%) who received PMRT and 85 (73.3%) who did not. At a median follow-up time of 56.4 months, the 5-year DFS and OS rates were 90.2% and 96.7% with PMRT and 93.7% and 97.3% without PMRT, respectively. PMRT did not affect either DFS (p = 0.234) or OS (p = 0.878). On multivariate analyses, no differences in DFS or OS between the two groups were detected, taking into consideration the following factors: age, molecular subtype, Ki67 index, cT stage, and in-breast pathologic complete response (DFS: HR 2.260; 95% CI 0.465–10.982; p = 0.312. OS: HR 1.400; 95% CI 0.138–14.202; p = 0.776). This nonsignificant difference was also consistent in subgroup analyses (all p > 0.05). Conclusions PMRT has limited ability to confer DFS or OS benefits for cT1-2N1 breast cancer patients who achieved axillary pathological complete response after NAC and total mastectomy. It is imperative to conduct prospective studies to investigate the safety and feasibility of omitting PMRT. Trial registration: This research was approved by the Ethics Committee of The First Affiliated Hospital of Chongqing Medical University (ID: No. 2021–442).https://doi.org/10.1007/s12672-022-00609-8Breast cancerNeoadjuvant chemotherapyPost mastectomy radiotherapy |
| spellingShingle | Yuran Dai Shishi Ma Ailin Lan Yihua Wang Yu Wang Yudi Jin Nan Ding Linshan Jiang Zhenrong Tang Xuedong Yin Yang Peng Shengchun Liu The impact of postmastectomy radiotherapy on cT1-2N1 breast cancer patients with ypN0 after neoadjuvant chemotherapy: a retrospective study based on real-world data Discover Oncology Breast cancer Neoadjuvant chemotherapy Post mastectomy radiotherapy |
| title | The impact of postmastectomy radiotherapy on cT1-2N1 breast cancer patients with ypN0 after neoadjuvant chemotherapy: a retrospective study based on real-world data |
| title_full | The impact of postmastectomy radiotherapy on cT1-2N1 breast cancer patients with ypN0 after neoadjuvant chemotherapy: a retrospective study based on real-world data |
| title_fullStr | The impact of postmastectomy radiotherapy on cT1-2N1 breast cancer patients with ypN0 after neoadjuvant chemotherapy: a retrospective study based on real-world data |
| title_full_unstemmed | The impact of postmastectomy radiotherapy on cT1-2N1 breast cancer patients with ypN0 after neoadjuvant chemotherapy: a retrospective study based on real-world data |
| title_short | The impact of postmastectomy radiotherapy on cT1-2N1 breast cancer patients with ypN0 after neoadjuvant chemotherapy: a retrospective study based on real-world data |
| title_sort | impact of postmastectomy radiotherapy on ct1 2n1 breast cancer patients with ypn0 after neoadjuvant chemotherapy a retrospective study based on real world data |
| topic | Breast cancer Neoadjuvant chemotherapy Post mastectomy radiotherapy |
| url | https://doi.org/10.1007/s12672-022-00609-8 |
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