声音审判对现实世界的影响
Andreas Giannakou1,2,3, Olga Kantor1,2,3, Ko Un Park1,2,3
1Division of Breast Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Annals of surgical oncology
|October 14, 2024
概括
哨兵淋巴结活检 (SLNB) 的省略对于早期,激素受体阳性,HER2阴性乳腺癌患者是安全的. 现实世界的数据显示了与SOUND试验类似的结果,支持其更广泛的采用.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- SOUND试验证实了省略哨兵淋巴结活检 (SLNB) 与用于早期乳腺癌 (BC) 的下部分期与负部超声波 (AxUS) 的非劣等性.
- 这些发现对激素受体阳性 (HR+),HER2-阴性 (HER2-) BC的概括性需要检查.
研究的目的:
- 评估HR+HER2-BC患者的真实世界队列中的瘤结果和节点疾病负担,符合SOUND试验资格标准.
- 评估结节状况和复发率评分对绝经后患者化疗建议的影响.
主要方法:
- 追溯分析312名HR+HER2-BC患者的cT1N0M0和阴性AxUS,他们接受了SLNB.
- 对临床病理学特征,疾病负担和瘤学结果与SOUND试验的SLNB分支进行比较.
- 基于结节状况和21基因复发得分的化疗建议的分析在绝经后的妇女中.
主要成果:
- 在312名符合条件的患者中,12.2%的患者呈阳性SLNB,只有0.4%的患者具有≥4个阳性节点.
- 在平均262个月的随访期间,没有观察到下复发和一个远程复发 (0.3%).
- 在复发分数≤25的绝经后妇女中,化疗建议与结节状况无关.
结论:
- 在现实世界中,符合SOUND标准的HR+HER2-BC患者表现出与试验人群相似的结节疾病负担和瘤结果.
- 在这个子组中,省略SLNB似乎是可行的和安全的,支持临床实施.
- 遗漏SLNB似乎不会影响低复发得分的绝经后患者的辅助化疗决策.
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