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Whole breast radiotherapy in cN0 early breast cancer patients with pathological sentinel lymph nodes (pN1mic, pN1a) without axillary dissection: preliminary results of the observational LISEN trial.
Ursini, Lucia Anna; Nuzzo, Marianna; Rosa, Consuelo; Borgia, Marzia; Caravatta, Luciana; Di Tommaso, Monica; Trignani, Marianna; Di Guglielmo, Fiorella Cristina; Ausili Cefaro, Giampiero; Angelucci, Domenico; Muzi, Marzia; Martino, Gianluigi; Cianchetti, Ettore; Grossi, Simona; Tavoletta, Saveria; Brocco, Davide; Grassadonia, Antonino; Tinari, Nicola; Gildetti, Simona; D'Ostilio, Nicola; Stuppia, Liborio; Porreca, Annamaria; Di Nicola, Marta; Genovesi, Domenico.
Affiliation
  • Ursini LA; Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Nuzzo M; Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Rosa C; Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy. c.rosa155@gmail.com.
  • Borgia M; Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy. c.rosa155@gmail.com.
  • Caravatta L; Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Di Tommaso M; Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Trignani M; Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Di Guglielmo FC; Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Ausili Cefaro G; Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Angelucci D; Department of Radiation Oncology, SS. Annunziata Hospital, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Muzi M; Department of Pathological Anatomy, ASL 02 Lanciano-Vasto-Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Martino G; Division of Breast Radiology, Department of Radiology, G. Bernabeo Hospital, Contrada Santa Liberata, 66026, Ortona, Chieti, Italy.
  • Cianchetti E; Department of Radiological Sciences, Institute of Nuclear Medicine, SS. Annunziata Hospital, Via dei Vestini, 66100, Chieti, Italy.
  • Grossi S; Division of Surgical Senology, G. Bernabeo Hospital, Contrada Santa Liberata, 66026, Ortona, Chieti, Italy.
  • Tavoletta S; Division of Surgical Senology, G. Bernabeo Hospital, Contrada Santa Liberata, 66026, Ortona, Chieti, Italy.
  • Brocco D; Division of Surgical Senology, G. Bernabeo Hospital, Contrada Santa Liberata, 66026, Ortona, Chieti, Italy.
  • Grassadonia A; Clinical Oncology Unit, SS. Annunziata Hospital, Via dei Vestini, 66100, Chieti, Italy.
  • Tinari N; Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Gildetti S; Department of Medical, Oral and Biotechnological Sciences and CeSI-MeT, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • D'Ostilio N; Department of Oncology, Floraspe Renzetti Hospital, Via per Fossacesia 1, Lanciano, 66034, Chieti, Italy.
  • Stuppia L; Department of Oncology, Floraspe Renzetti Hospital, Via per Fossacesia 1, Lanciano, 66034, Chieti, Italy.
  • Porreca A; Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
  • Di Nicola M; Department of Economics, "G. D'Annunzio" University of Chieti-Pescara, Pescara, Italy.
  • Genovesi D; Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti, Via dei Vestini, 66100, Chieti, Italy.
Strahlenther Onkol ; 198(7): 612-621, 2022 07.
Article in En | MEDLINE | ID: mdl-35499695
PURPOSE: Axillary management remains unclear when sentinel lymph node (SLN) results are positive in cN0 patients with breast cancer (BC). The trial ACOSOG Z0011 represented a revolution with axillary lymph node dissection (ALND) omission in SLN+ patients, despite critiques regarding non-uniformity of radiation fields. We conducted an observational study (LISEN) where whole breast radiotherapy (WBRT) was planned with tangential fields without nodal irradiation in patients eligible for the Z0011 trial. METHODS: Inclusion criteria were female patients with histologically proven BC, cT1-2cN0, planned conservative surgery, no neoadjuvant therapy. Patients were stratified into two groups: micrometastatic (pN1mic, group 1) and macrometastatic (pN1a, group 2) lymph nodes. Tangential field WBRT was mandatory. Clinical outcomes were analysed, measured from surgery until the first event. RESULTS: In all, 199 patients underwent conservative surgery and SLN biopsy; 133 patients meeting criteria were analysed: 41 patients (30.8%) pN1mic and 92 (69.2%) pN1a. The 5­year disease-free survival (DFS) was 95.0% (85.9-100%) in group 1 and 93.0% (86.3-100.0%) in group 2 (p = 0.78). Overall survival (OS) was 100% (100-100%) in group 1 and 97.4% (92.4-100%) in group 2 (p = 0.74). For the whole cohort DFS and OS were 93.6% (88.2-99.4%) and 96.9% (91.5-100.0%), respectively. For groups 1 and 2, the 5­year outcomes were 5.0% (0.0-14.4%) and 2.3% (0.0-6.1%) for local recurrence (p = 0.51), and 6.2% (0.0-17.4%) and 7.0% (0.0-13.7%) for distant metastasis (p = 0.61), respectively. In group 1, regional recurrence (RR) and local regional recurrence (LRR) were 5.0% (0.0-14.1%; p = 0.13). In group 2, RR and LRR were 0.0% (0.0-0.0%). CONCLUSION: Our results showed good regional control in patients who met the Z0011 trial criteria. WBRT, without nodal surgery or RT, avoiding axillary morbidity, seems to be a good choice.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Breast Neoplasms / Sentinel Lymph Node Type of study: Observational_studies Limits: Female / Humans / Male Language: En Journal: Strahlenther Onkol Journal subject: NEOPLASIAS / RADIOTERAPIA Year: 2022 Document type: Article Affiliation country: Italy Country of publication: Germany
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Breast Neoplasms / Sentinel Lymph Node Type of study: Observational_studies Limits: Female / Humans / Male Language: En Journal: Strahlenther Onkol Journal subject: NEOPLASIAS / RADIOTERAPIA Year: 2022 Document type: Article Affiliation country: Italy Country of publication: Germany