2026-04-17T11:25:26Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/4663612026-03-28T08:23:33Zcom_2072_98col_2072_378192

00925njm 22002777a 4500 dc Vieites, B. author López-García, M. author Martín-Salvago, M.D. author Ramírez Tortosa, César Luis author Rezola, R. author Sancho, M. author López Vilaró, Laura author Villardell, F. author Burgués, Octavio author Fernández-Rodriguez, B. author Alfaro, L. author Peg, Vicente author 2021 Altres ajuts: Sysmex España S.L. Objective: To evaluate the predictive and prognostic value of total tumor load (TTL) in sentinel lymph nodes (SLNs) in patients with infiltrating breast cancer after neoadjuvant systemic therapy (NST). Methods: This retrospective multicenter study used data from a Spanish Sentinel Lymph Node database. Patients underwent intraoperative SLN biopsy after NST. TTL was determined from whole nodes using a one-step nucleic acid amplification (OSNA) assay and defined as the total sum of CK19 mRNA copies in all positive SLNs. Cox-regression models identified independent predictive variables, which were incorporated into a nomogram to predict axillary non-SLN metastasis, and identified prognostic variables for incorporation into a disease-free survival (DFS) prognostic score. Results: A total of 314 patients were included; most had no lymph node involvement prior to NST (cN0; 75.0% of patients). Most received chemotherapy with or without biologic therapy (91.7%), and 81 patients had a pathologic complete response. TTL was predictive of non-SLN involvement (area under the concentration curve = 0.87), and at a cut-off of 15,000 copies/µL had a negative predictive value of 90.5%. Nomogram parameters included log (TTL + 1), maximum tumor diameter and study-defined NST response. TTL was prognostic of disease recurrence and DFS at a cut-off of 25,000 copies/µL. After a 5-year follow-up, DFS was higher in patients with ≤ 25,000 copies/µL than those with. Breast cancer Disease-free survival Neoadjuvant systemic therapy OSNA Sentinel lymph node Total tumor load Predictive and prognostic value of total tumor load in sentinel lymph nodes in breast cancer patients after neoadjuvant treatment using one-step nucleic acid amplification : the NEOVATTL study