The impact of peri-operative chemotherapy for patients with lymph node-positive urothelial cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 388-388
Author(s):  
Jeenan Kaiser ◽  
Haocheng Li ◽  
Richard M. Lee-Ying ◽  
Daniel Yick Chin Heng ◽  
Nimira S. Alimohamed
Keyword(s):  
Lymph Node ◽  
Surgical Management ◽  
Urothelial Cancer ◽  
Locally Advanced ◽  
Cox Regression Analysis ◽  
Chemotherapy Group ◽  
T Stage ◽  
Group A ◽  
N Stage ◽  
The Impact

388 Background: Patients with locally advanced urothelial cancer with regional lymph node involvement (LN+) have a poor prognosis. Surgical management of these patients is controversial and practice patterns vary. We evaluated the outcomes of patients with LN+ disease treated with pre-operative chemotherapy and cystectomy, cystectomy and post-operative chemotherapy, and chemotherapy alone. Methods: Patients with urothelial cancer with TxN1-3M0 disease treated with chemotherapy in Alberta from 2005 to 2015 were evaluated. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier analysis. Cox regression analysis was performed to evaluate the impact of age, gender, T stage, and N stage on survival. Results: 184 patients with LN+ disease treated with chemotherapy were evaluable for outcomes; 42 underwent pre-operative chemotherapy (Group A), 92 underwent post-operative chemotherapy (Group B), and 50 received chemotherapy alone (Group C). The median age at diagnosis was 65 years (range 31-89) and most patients (83%) were male. The median follow-up time was 23.2 months. A higher T stage was seen in patients in Group A, while patients in Group C had a higher N stage. The median number of chemotherapy cycles delivered was equal in all arms at 4. Patients in Group A or B had significantly better PFS and OS compared with patients in Group C (Table). When adjusting for age, gender, T stage, and N stage, patients in Group C had significantly lower OS compared with those patients in Group A (HR 1.87, 95% CI 1.09 – 3.18, p=0.02). Conclusions: In this real-world analysis of patients with LN+ urothelial cancer, patient outcomes were improved with surgical resection of disease in combination with pre-operative chemotherapy. After chemotherapy in fit patients with LN+ disease, surgical management is a reasonable consideration. [Table: see text]

scholarly journals Impact of resection margin status on survival in advanced N stage pancreatic cancer – a multi-institutional analysis

2021 ◽  
Author(s):  
Christian Teske ◽  
Richard Stimpel ◽  
Marius Distler ◽  
Susanne Merkel ◽  
Robert Grützmann ◽  
...  
Keyword(s):  
Lymph Node ◽  
Resection Margin ◽  
Cox Regression ◽  
Institutional Analysis ◽  
Ductal Adenocarcinoma ◽  
Resection Margins ◽  
Lymph Node Status ◽  
Cox Regression Analysis ◽  
N Stage ◽  
The Impact

Abstract Background The present study aimed to examine the impact of microscopically tumour-infiltrated resection margins (R1) in pancreatic ductal adenocarcinoma (PDAC) patients with advanced lymphonodular metastasis (pN1–pN2) on overall survival (OS). Methods This retrospective, multi-institutional analysis included patients undergoing surgical resection for PDAC at three tertiary university centres between 2005 and 2018. Subcohorts of patients with lymph node status pN0–N2 were stratified according to the histopathological resection status using Kaplan-Meier survival analysis. Results The OS of the entire cohort (n = 620) correlated inversely with the pN status (26 [pN0], 18 [pN1], 11.8 [pN2] months, P < 0.001) and R status (21.7 [R0], 12.5 [R1] months, P < 0.001). However, there was no statistically significant OS difference between R0 versus R1 in cases with advanced lymphonodular metastases: 19.6 months (95% CI: 17.4–20.9) versus 13.6 months (95% CI: 10.7–18.0) for pN1 stage and 13.7 months (95% CI: 10.7–18.9) versus 10.1 months (95% CI: 7.9–19.1) for pN2, respectively. Accordingly, N stage–dependent Cox regression analysis revealed that R status was a prognostic factor in pN0 cases only. Furthermore, there was no significant survival disadvantage for patients with R0 resection but circumferential resection margin invasion (≤ 1 mm; CRM+; 10.7 months) versus CRM-negative (13.7 months) cases in pN2 stages (P = 0.5). Conclusions An R1 resection is not associated with worse OS in pN2 cases. If there is evidence of advanced lymph node metastasis and a re-resection due to an R1 situation (e.g. at venous or arterial vessels) may substantially increase the perioperative risk, margin clearance in order to reach local control might be avoided with respect to the OS.

scholarly journals Impact of Pancreatic Resection on Survival in Locally Advanced Resectable Gastric Cancer

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1289
Author(s):  
Shih-Chun Chang ◽  
Chi-Ming Tang ◽  
Puo-Hsien Le ◽  
Chia-Jung Kuo ◽  
Tsung-Hsing Chen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Pancreatic Resection ◽  
Locally Advanced ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Complication Rates ◽  
Lymph Node Yield ◽  
Whipple’S Operation ◽  
Whipple's Operation ◽  
The Impact

Whether gastric adenocarcinoma (GC) patients with adjacent organ invasion (T4b) benefit from aggressive surgery involving pancreatic resection (PR) remains unclear. This study aimed to clarify the impact of PR on survival in patients with locally advanced resectable GC. Between 1995 and 2017, patients with locally advanced GC undergoing radical-intent gastrectomy with and without PR were enrolled and stratified into four groups: group 1 (G1), pT4b without pancreatic resection (PR); group 2 (G2), pT4b with PR; group 3 (G3), positive duodenal margins without Whipple’s operation; and group 4 (G4), cT4b with Whipple’s operation. Demographics, clinicopathological features, and outcomes were compared between G1 and G2 and G3 and G4. G2 patients were more likely to have perineural invasion than G1 patients (80.6% vs. 50%, p < 0.001). G4 patients had higher lymph node yield (40.8 vs. 31.3, p = 0.002), lower nodal status (p = 0.029), lower lymph node ratios (0.20 vs. 0.48, p < 0.0001) and higher complication rates (45.2% vs. 26.3%, p = 0.047) than G3 patients. The 5-year disease-free survival (DFS) and overall survival (OS) rates were significantly longer in G1 than in G2 (28.1% vs. 9.3%, p = 0.003; 32% vs. 13%, p = 0.004, respectively). The 5-year survival rates did not differ between G4 and G3 (DFS: 14% vs. 14.4%, p = 0.384; OS: 12.6% vs. 16.4%, p = 0.321, respectively). In conclusion, patients with T4b lesion who underwent PR had poorer survival than those who underwent resection of other adjacent organs. Further Whipple’s operation did not improve survival in pT3–pT4 GC with positive duodenal margins.

Postoperative detection of circulating EGFR transcripts as a surrogate marker for circulating tumor cells to predict tumor recurrence after adjuvant radio(chemo)therapy in locally advanced squamous cell carcinoma of the head and neck (LASCCHN).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6014-6014 ◽  
Author(s):  
Inge Tinhofer ◽  
Robert Konschak ◽  
Carmen Stromberger ◽  
Ulrich Keilholz ◽  
Volker Budach
Keyword(s):  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Adjuvant Treatment ◽  
Tumor Recurrence ◽  
Locally Advanced ◽  
Surrogate Marker ◽  
Smoking History ◽  
Blood Samples ◽  
Cox Regression Analysis ◽  
N Stage

6014 Background: The prognostic role of circulating tumor cells (CTCs), occurring in up to 35% of LASCCHN patients, is still largely undetermined. In this prospective study we tested whether the detection of CTCs was associated with treatment outcome of adjuvant radio(chemo)therapy. Methods: Patients with LASCCHN (N=64) of the oropharynx (N=40), oral cavity (N=15), hypopharynx (N=3) or CUP (N=6) presenting after tumor surgery for adjuvant treatment were enrolled in this study. Peripheral blood samples were collected before start and at the end of adjuvant radio- (N=22) or radiochemotherapy (N=42). Transcripts of epidermal growth factor receptor (EGFR) were detected using RT-PCR. Samples positive in at least 2 of 3 PCR replicates were considered CTC-positive, according to previous studies. CTC detection was correlated with failure-free (FFS) and overall survival (OS). Results: CTCs were detected in blood samples from 21 of 64 patients (33%) whereas all 30 samples from healthy donors used as control were negative. The CTC+ and CTC- patient cohorts were comparable with relation to sex, age, smoking history, T and N stage, tumor localization, type of adjuvant treatment and the median follow-up for OS and FFS. Detection of CTCs before or after adjuvant treatment was not predictive for OS. However, the presence of CTCs at the start of adjuvant radio(chemo)therapy identified patients with reduced FFS (CTC- vs CTC+ [% of patients without relapse at 2 years]: 89% vs. 60%, HR: 0.30, 95% CI: .08-.92, p=.037). Multivariate Cox regression analysis revealed that the prognostic value of the CTC status was not influenced by the T and N stage and independent of whether the adjuvant treatment consisted of radio- or radiochemotherapy. Conclusions: Persistence of CTCs after tumor resection as detected by EGFR transcripts was established as an independent marker for tumor recurrence in LASCCHN. Postoperative detection of CTCs might prove useful for risk stratification in future clinical trials for optimization of adjuvant treatment, especially for the poor-prognosis group of CTC+ patients.

Testosterone recovery as biomarker for overall and cause-specific survival in combined treated patients with high-risk and locally advanced prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 188-188
Author(s):  
Mathew Deek ◽  
Victoria Vaage ◽  
Knut H. Hole ◽  
Theodore L. DeWeese ◽  
Andreas Stensvold ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Median Time ◽  
Locally Advanced ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Cause Specific Survival

188 Background: Androgen deprivation therapy (ADT) can cause considerable toxicity and may influence outcome. The study assessed the impact of testosterone recovery (TR) on survival after ADT and definitive radiotherapy in two independent cohorts. Methods: Two hundred and forty-four patients (high risk JHH cohort N=106, T1c-T3N0M0 [A], locally advanced OUH cohort N=138, T1c-T4N0-1M0 [B]) with adenocarcinoma of the prostate were included in this retrospective analysis. Short and long-term ADT was given (median 12 months A, 24 months B, respectively,) and along with conformal external beam radiation 76-80 Gy given to the prostate in cohort A, 74 Gy prescribed in cohort B and 46-50 Gy to the whole pelvis. Testosterone levels were measured at the end of ADT and at biochemical relapse. TR was defined as ≥ 9 nmol/L. Kaplan Meier plots were generated for overall survival (OS) and cause-specific survival (CSS) stratified by TR, in addition to patient characteristics median time to TR and FU were calculated. Results: The median age in the A cohort was 66.7 years and 64.7 years in the B group. FU was 6 years for A and 8 years in B. Patients in group A received median ADT of 12 months and 24 months in group B. The median time to TR was 1.6 yr in A and 2.5 yrs in B, respectively. Patients in group A stratified to TR showed no difference in overall survival (p=0.92)), on contrary, patients in group B showed improved overall survival depending on TR (Fig. 1, KM plot, 10 year OS 75.3% vs 59.9% p=0.034). CSS was seemed to trend towards improvement with TR for cohort A (p=0.19) and was improved in cohort B (p=0.022). The Univariate ADT length, age, and RT dose was associated with time to TR, but on multivariate analysis only longer ADT time (p = 0.03) was significantly associated with time to TR. Conclusions: TR was associated with improved OS in patients with unfavorable locally advanced disease a finding not seen in patients with high-risk disease.

scholarly journals Development and Validation of Nomograms to Predict Prognosis of Oral and Oropharyngeal Mucoepidermoid Carcinoma: A SEER-Based Study

2020 ◽  
Author(s):  
muyuan liu ◽  
Litian Tong ◽  
Manbin Xu ◽  
Xiang Xu ◽  
Bin Liang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Mucoepidermoid Carcinoma ◽  
Cox Regression ◽  
Seer Database ◽  
Disease Specific Survival ◽  
Cox Regression Analysis ◽  
T Stage ◽  
N Stage ◽  
Disease Specific

Abstract Background: Due to the low incidence of mucoepidermoid carcinoma, there lacks sufficient studies for determining optimal treatment and predicting prognosis. The purpose of this study was to develop prognostic nomograms, to predict overall survival and disease-specific survival (DSS) of oral and oropharyngeal mucoepidermoid carcinoma patients, using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. Methods: Clinicopathological and follow-up data of patients diagnosed with oral and oropharyngeal mucoepidermoid carcinoma between 2004 and 2017 were collected from the SEER database. The Kaplan-Meier method with the log-rank test was employed to identify single prognostic factors. Multivariate Cox regression was utilized to identify independent prognostic factors. C-index, area under the ROC curve (AUC) and calibration curves were used to assess performance of the prognostic nomograms. Results: A total of 1230 patients with oral and oropharyngeal mucoepidermoid carcinoma were enrolled in the present study. After multivariate Cox regression analysis, age, sex, tumor subsite, T stage, N stage, M stage, grade and surgery were identified as independent prognostic factors for overall survival. T stage, N stage, M stage, grade and surgery were identified as independent prognostic factors for disease-specific survival. Nomograms were constructed to predict the overall survival and disease-specific survival based on the independent prognostic factors. The fitted nomograms possessed excellent prediction accuracy, with a C-index of 0.899 for OS prediction and 0.893 for DSS prediction. Internal validation by computing the bootstrap calibration plots, using the validation set, indicated excellent performance by the nomograms. Conclusion: The prognostic nomograms developed, based on individual clinicopathological characteristics, in the present study, accurately predicted the overall survival and disease-specific survival of patients with oral and oropharyngeal mucoepidermoid carcinoma.

scholarly journals Long-term outcomes of moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for prostate cancer confined to the pelvis: A single center retrospective analysis

2020 ◽  
Author(s):  
Lihong Yao ◽  
Jianzhong Shou ◽  
Shulian Wang ◽  
Yongwen Song ◽  
Hui Fang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Locally Advanced ◽  
Chinese Patients ◽  
Hypofractionated Radiotherapy ◽  
Long Term Outcomes ◽  
T Stage ◽  
Fractionation Schedule ◽  
N Stage

Abstract Background: There is an increasing application of moderately hypofractionated radiotherapy for prostate cancer. We presented our outcomes and treatment-related toxicities with moderately hypofractionated (67.5 Gy in 25 fractions) radiotherapy for a group of advanced prostate cancer patients from China.Methods: From November 2006 to December 2018, 246 consecutive patients with prostate cancer confined to the pelvis were treated with moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions). 97.6% of the patients received a different duration of androgen deprivation therapy. Failure-free survival (FFS), prostate cancer-specific survival (PCSS), overall survival (OS), and cumulative grade ≥2 late toxicity were evaluated using the Kaplan-Meier actuarial method. Prognostic factors for FFS, PCSS, and OS were analyzed.Results: The median follow-up time was 74 months (range: 6-150 months). For all patients, the 5- and 10-year FFS rates were 80.0% (95%CI: 74.7%-85.7%) and 63.5% (95%CI: 55.4%-72.8%). The failure rates for the intermediate, high-risk, locally advanced, and N1 groups were 6.1%, 13.0%, 18.4%, and 35.7%, respectively (P = 0.003). Overall, 5- and 10-year PCSS rates were 95.7% (95%CI: 93.0%-98.5%) and 88.2% (95%CI: 82.8%-93.8%). Prostate cancer-specific mortality rates for the high-risk, locally advanced, and N1 groups were 4.0%, 8.2%, and 23.8%, respectively (P＜0.001). Overall, 5- and 10-year actuarial OS rates were 92.4% (95%CI: 88.8%-96.1%) and 72.7% (95%CI: 64.8%-81.5%). High level prostate-specific antigen and positive N stage were significantly associated with worse FFS (P＜0.05). Advanced T stage and positive N stage emerged as worse predictors of PCSS (P＜0.05). Advanced age, T stage, and positive N stage were the only factors that were significantly associated with worse OS (P＜0.05). The 5-year cumulative incidence rate of grade ≥ 2 late GU and GI toxicity was 17.8% (95%CI: 12.5%-22.7%) and 23.4% (95%CI: 17.7%-28.7%), respectively. Conclusions: Moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for this predominantly high-risk, locally advanced, or N1 in Chinese patients demonstrates encouraging long-term outcomes and acceptable toxicity. This fractionation schedule deserves further evaluation in similar populations.

PS01.196: SHORT-TERM AND MEDIUM-TERM OUTCOMES IN PATIENTS OVER 70 DIAGNOSED WITH OESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 105-105
Author(s):  
Anantha Madhavan ◽  
Nicola Wyatt ◽  
Charlotte Boreham ◽  
Alexander Phillips ◽  
S Michael Griffin
Keyword(s):  
Oesophageal Cancer ◽  
Conflicts Of Interest ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Major Complication ◽  
Radio Therapy ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Background Oesophageal cancer incidence has increased over the last decade in the UK, particularly in older patients. Surgery, with or without perioperative chemotherapy, remains the gold standard treatment for patients with potentially curable disease. Currently, 41% of new cases of oesophageal cancer are in patients aged over 70. However, only 10% underwent surgery compared to 25% of those aged under 70. Concerns exist that advanced age may prejudice treatment decisions. The aim of our review is to evaluate the impact of age on outcomes in those undergoing planned curative treatment for oesophageal cancer. Methods A retrospective review of patients undergoing oesophagectomy for carcinoma between 2006 to 2016 at a single institution was performed. Patients were divided into two cohorts based on age at the time of diagnosis; under 70 years (Group A) and over 70 (Group B). Patients underwent a standardised staging protocol and treatment was decided by a multi-disciplinary team. Oesophagectomy was performed using a transthoracic approach with two field lymphadenectomy and perioperative chemo (radio) therapy used in those patients with locally advanced disease who were fit enough. Results There were 555 patients in Group A and 241 in Group B. Adenocarcinoma was the prevalent histological subtype in both cohorts: 76% (423) in Group A and 68% (165) in Group B. Median age at the time of diagnosis was 62 in Group A versus 74 in Group B. In Group A, 12% (18/343) did not receive neo-adjuvant treatment for locally advanced cancer versus 47% (101/212) in Group B (P < 0.001). Median hospital stay was longer in Group B (18 v 15 days P = 0.02). There was no significant difference in hospital mortality (Group A 1% vs Group B 2.4% P = 0.37) and major complication rate (Group A 14% vs Group B 20% P = 0.31). Two-year survival was 66% (adenocarcinoma) and 78% (SCC) in Group A compared to 60% (adenocarcinoma) and 64% (SCC) in Group B. Conclusion These results demonstrate that patients over 70 can be treated successfully with minimal additional risk to morbidity and mortality. However, these patients are more likely to be denied neoadjuvant treatment which may compromise their long-term outcomes. Disclosure All authors have declared no conflicts of interest.

PS02.106: THE IMPACT OF HISTOPATHOLOGICAL LYMPH NODE METASTASES AFTER PREOPERATIVE CHEMO-RADIOTHERAPY ON THE PROGNOSIS IN ESOPHAGEAL CANCER PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 151-151
Author(s):  
Kentaro Murakami
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Lymph Node Metastases ◽  
Conflicts Of Interest ◽  
Locally Advanced ◽  
The United States ◽  
Node Metastases ◽  
The Impact

Abstract Background Esophageal cancer does not have a good prognosis despite being resectable. A recent randomized controlled trial (the Dutch CROSS study) showed the superiority of preoperative chemo-radiotherapy over surgery alone with regard to the five-year survival. At present, this therapeutic approach is regarded as the standard care in the United States and Europe. However, the prognosis in cases where part of the tumor remains is poor, so additional adjuvant therapy is required. The impact of the histopathological lymph node metastases status after preoperative chemo-radiotherapy on the prognosis is unknown, and is which patients require additional adjuvant therapy to manage lymph node metastases. Methods Esophageal cancer patients with more than five lymph node metastases or lymph node metastases spreading into three fields have a poor prognosis, despite their tumor being resectable. We therefore performed neoadjuvant chemo-radiotherapy in these patients in 1998 (NACRT group). We also performed chemo-radiotherapy for initially unresectable locally advanced esophageal cancer invading adjacent organs and curative surgery for the above-mentioned patients in whom the invasion had disappeared after chemo-radiotherapy (conversion group). The chemo-radiotherapy regimen was the same for both groups and consisted of radiotherapy 40 Gy/20 fr and chemotherapy with 5-FU (500 mg/m2 days 0–4) and CDDP (15 mg/m2 days 1–5). We then examined the impact of the histopathological lymph node metastasis status after preoperative chemo-radiotherapy on the prognosis in our institute. Results Patients with three or more histopathological lymph node metastases had a significantly poorer prognosis than those with fewer metastases in both groups. In the NACRT group, the 5-year survival rate was 35.5% vs. 36.1% (number of lymph node metastases 0 vs. ≥ 1; P = 0.889), 34.0% vs. 36.7% (0–1 vs. ≥ 2; P = 0.678), and 47.1% vs. 0% (0–2 vs. ≥ 3; P = 0.003). In conversion group, it was 40.4% vs. 43.6% (number of lymph node metastases 0 vs. ≥ 1; P = 0.841), 45.6% vs. 33.6% (0–1 vs. ≥ 2; P = 0.106), and 49.5% vs. 20.0% (0–2 vs. ≥ 3; P = 0.025). Conclusion Patients with three or more histopathological lymph node metastases after preoperative chemo-radiotherapy had a significantly poorer prognosis than those with fewer metastases and required additional adjuvant therapy. Disclosure All authors have declared no conflicts of interest.

Feasibility of sentinel node biopsy in patients with locally advanced breast cancer after neoadjuvant therapy: A pilot study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1120-1120
Author(s):  
Ariadna Tibau Martorell ◽  
Joan Duch ◽  
Maria Jesus Quintana ◽  
Laura Lopez Vilaro ◽  
Belen Ojeda ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Advanced Breast Cancer ◽  
Neoadjuvant Therapy ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
False Negative ◽  
Node Negative ◽  
Node Biopsy ◽  
Group A

1120 Background: Sentinel lymph node biopsy (SLNB) is a widely used staging method for patients with early breast cancer. Neoadjuvant Therapy (NT) modifies the anatomical conditions in the breast and axilla, and thus reliability of SLNB after NT remains controversial. The aim of this study is to prospectively evaluate the feasibility and accuracy of this procedure in this particular group of patients. Methods: Between December 2007-2011, 69 patients (mean age 56 years) with locally advanced breast cancer (LABC) were prospectively studied. Patients were T1-4, N0-1, M0. Prior to surgery, 61 patients received chemotherapy (CT) (adryamicin/cyclophosphamide followed by docetaxel) and 8 patients endocrine therapy (ET). Thirty nine patients were initially node-negative (cN0) and 30 patients had clinical/ultrasound node-positive confirmed by cytology (cN1) at presentation. All patients were clinical and ultrasound node-negative after NT. The study contained two groups of patients: group A (validation) included the first 29, associated with an axillary lymph node dissection (ALND) after NT, in order to validate the study, and group B included the last 40, only associated with an ALND when SLNB was positive or not found. Results: Whole SLNB identification rate was 89.9%, and no significant differences were found between patients initially cN0 (92%; 36/39) and initially cN1 (87%; 26/30). Four of 7 patients in whom SLNB was not found had residual nodal metastasis after NT (3 of them were initially cN1). Sentinel lymph nodes were successfully identified in 87% (7/8) of patients after ET and in 90% (55/61) of patients after CT. There was one false negative (FN) case after CT in group A (9% of overall false negative rate, initially cN0) and there were no FN cases after ET. Positive SLNB were higher in initially cN1 group (53%; 16/30) than in initially cN0 group (18%; 7/39). Conclusions: SLNB after NT (CT or ET) is safe and feasible in patients with LABC, not only in initially cN0 but also in initially cN1. It accurately predicts the status of the axilla and avoids unnecessary ALND.

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