PurposeEndoscopic submucosal dissection (ESD) in early gastric cancer causes an artificial gastric ulcer and local inflammation that has a negative intraprocedural impact on additional laparoscopic gastrectomy in patients with noncurative ESD. In this study, we analyzed the effect of ESD on short-term surgical outcomes and evaluated the risk factors.Materials and MethodsFrom January 2003 to January 2013, 1,704 patients of the National Cancer Center underwent laparoscopic gastrectomy with lymph node dissection because of preoperative stage Ia or Ib gastric cancer. They were divided into 2 groups: (1) with preoperative ESD or (2) without preoperative ESD. Clinicopathologic factors and short-term surgical outcomes were retrospectively evaluated along with risk factors such as preoperative ESD.ResultsSeveral characteristics differed between patients who underwent ESD-surgery (n=199) or surgery alone (n=1,505). The mean interval from the ESD procedure to the operation was 43.03 days. Estimated blood loss, open conversion rate, mean operation time, and length of hospital stay were not different between the 2 groups. Postoperative complications occurred in 23 patients (11.56%) in the ESD-surgery group and in 189 patients (12.56%) in the surgery-only group, and 3 deaths occurred among patients with complications (1 patient [ESD-surgery group] vs. 2 patients [surgery-only group]; P=0.688). A history of ESD was not significantly associated with postoperative complications (P=0.688). Multivariate analysis showed that male sex (P=0.008) and laparoscopic total or proximal gastrectomy (P=0.000) were independently associated with postoperative complications.ConclusionsESD did not affect short-term surgical outcomes during and after an additional laparoscopic gastrectomy.

Objective: This study aimed to evaluate the outcomes between sentinel lymph node biopsy (SLNB) and axillar lymph node dissection (ALND) on recurrence and survival in clinically node positive breast cancer patients who showed conversion into pN0 after neoadjuvant chemotherapy (NAC) from 10 years cohort in single center. Materials & Method: This study enrolled total 225 patients, from January 2006 to December 2015 who underwent breast cancer surgery and axillar lymph node approach in clinically axillar lymph node metastasis with conversion into node negative after neoadjuvant chemotherapy. One hundred patients had only SLNB and 125 patients had ALND finally. Results: The median follow-up time was 58 months (range, 12-147 months) in only SLNB group and 103 months (range 9-174 months) in ALND group and the median number of retrieved SLNs was 2 (range, 1-6) and 11 (2-31). The 5 years overall survival rate of SLNB and ALND group is 94%, 95.7% (P=0.786), disease free survival rate 91.9%, 91.6%, (p=0.753) which was not statistically significant. Three patients (3%) and 6 patients (4.8%) showed loco-regional recurrence respectively. All they showed ipsilateral axillary lymph node recurrence. Seven patients (7%) and 6 patients (4.8%) in SLNB group and ALND group showed distant metastasis. However, there were more complications in the ALND group than in the SLNB group. Among them, ALND group showed the higher rate of shoulder stiffness than SLNB group (7% vs 10.4%, p=0.384, respectively). Especially, the incidence of lymphedema was 6 times higher in ALND group. (4 patients (4%) vs 29 patients (23.2%), p=0.271) Conclusion: We found the SLNB only group did not increase the recurrence or metastatic rate from the patients, but reduced the incidence of complications such as lymphedema from the 10 years single center cohort. Therefore, we suggest SLNB can be considered as a reliable as an alternative to ALND when the complete response is achieved by re-staging with imaging study after neoadjuvant chemotherapy. Keyword: neoadjuvant chemotherapy, sentinel lymph node biopsy, axillar lymph node dissection Citation Format: Joo Hwa Kwak, Heein Jo, Eun-Gyeong Lee, Eun Jin Song, Jai Hong Han, So-Youn Jung, Han-Sung Kang, Eun Sook Lee, Seeyoun Lee. What happened to clinically node positive breast cancer patients who showed conversion into pN0 after neoadjuvant chemotherapy?: Single center for 10 years [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-02-08.