Wang Jiwei, Wang Xing, He Yingjian, Wang Tianfeng, Li Jinfeng, Fan Zhaoqing, Ouyang Tao
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Center, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Clin Breast Cancer. 2025 Jul;25(5):e555-e560. doi: 10.1016/j.clbc.2025.02.006. Epub 2025 Feb 12.
We aimed to determine whether patients with cytologically proven node-positive disease who achieved axillary pathologic complete response (ypN0) after neoadjuvant chemotherapy (NAC) have similar survival outcomes to those with initially pathologically negative lymph nodes (pN0).
Patients with cytologically proven node-positive breast cancer who achieved ypN0 after NAC and those with pN0 between June 2005 and March 2012 in a large cancer hospital were reviewed. The relapse-free survival (RFS), distant-disease-free survival (DDFS) and overall survival (OS) of the 2 groups were calculated and compared.
A total of 2285 patients, including 183 patients with ypN0 and 2102 patients with pN0, were included in this study. The median follow-up time for patients was 121 (range 2-182) months. The 10-year cumulative RFS was 79.7% for ypN0 patients and 90.2% for pN0 patients (log-rank P < .001). The 10-year cumulative DDFS was 81.4% for ypN0 patients and 92.2% for pN0 patients (log-rank P < .001). The 10-year cumulative OS was 86.3% for ypN0 patients and 94.0% for pN0 patients (log-rank P < .001). The multivariable Cox proportional hazards models showed that compared with pN0 patients, ypN0 patients had a 2.00-fold increase in the risk of recurrence (HR = 2.00, 95% CI, 1.33-3.01, P = .001), a 2.34-fold increase in the risk of distant recurrence (HR = 2.34, 95% CI, 1.52-3.62, P < .001) and a 2.10-fold increase in the risk of death (HR = 2.10, 95% CI, 1.25-3.53, P = .005).
Patients with axillary pCR showed inferior RFS, DDFS and OS to patients with pN0.
我们旨在确定经细胞学证实为淋巴结阳性疾病且在新辅助化疗（NAC）后达到腋窝病理完全缓解（ypN0）的患者与最初病理检查淋巴结阴性（pN0）的患者是否具有相似的生存结果。
对在一家大型癌症医院2005年6月至2012年3月期间经细胞学证实为淋巴结阳性乳腺癌且NAC后达到ypN0的患者以及pN0患者进行回顾性分析。计算并比较两组患者的无复发生存期（RFS）、无远处疾病生存期（DDFS）和总生存期（OS）。
本研究共纳入2285例患者，其中包括183例ypN0患者和2102例pN0患者。患者的中位随访时间为121（范围2 - 182）个月。ypN0患者的10年累积RFS为79.7%，pN0患者为90.2%（对数秩检验P <.001）。ypN0患者的10年累积DDFS为81.4%，pN0患者为92.2%（对数秩检验P <.001）。ypN0患者的10年累积OS为86.3%，pN0患者为94.0%（对数秩检验P <.001）。多变量Cox比例风险模型显示，与pN0患者相比，ypN0患者复发风险增加2.00倍（HR = 2.00，95%CI，1.33 - 3.01，P =.001），远处复发风险增加2.34倍（HR = 2.34，95%CI，1.52 - 3.62，P <.001），死亡风险增加2.10倍（HR = 2.10，95%CI，1.25 - 3.53，P =.005）。
腋窝病理完全缓解的患者与pN0患者相比，RFS、DDFS和OS较差。
