Aggressive Surgical Excision of Supraclavicular Lymph Node Did Not Improve the Outcomes of Breast Cancer With Supraclavicular Lymph Node Involvement (KROG 16-14)

Kim, Kyubo; Kim, Su Ssan; Shin, Kyung Hwan; Kim, Jin Ho; Ahn, Seung Do; Choi, Doo Ho; Park, Won; Lee, Sun Young; Chun, Mison; Kim, Jin Hee; Kim, Yong Bae; Cha, Jae-Young; Park, Hae Jin; Lee, Dong Hoon; Jung, Wonguen

doi:10.1016/j.clbc.2019.09.004

Cited by 8 publications

(7 citation statements)

References 13 publications

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“…These findings supported that combined therapy can improve the survival outcomes of mISLM patients and were in agreement with those of current mainstream studies. [9][10][11][12] Additionally, we found in the multivariate analyses that the pN3 stage was an important factor affecting PFS. This indicated that ISLM patients with pN3 stage had a higher risk of supraclavicular lymph node failure and were more likely to develop disease progression, which was also consistent with the previous results of Fan et al And this may be related to the micrometastasis of tumor cells in supraclavicular vessels.…”

Section: Discussionmentioning

confidence: 62%

“…A trial from South Korea found that aggressive regional surgery did not improve locoregional control or survival. 10 And in a recently published article, Ai et al 20 conducted a study of 305 patients with ISLM and found that supraclavicular lymph node dissection may not be beneficial in improving survival for unselected breast cancer patients with ISLM. Furthermore, in a study of Zhang et al, experts found that the benefit of neck surgery in ISLM patients may be related to pathological classification.…”

Section: Discussionmentioning

confidence: 99%

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<p>Combined Therapy Can Improve the Outcomes of Breast Cancer with Isolated Supraclavicular Lymph Node Involvement</p>

Ma¹,

Mao²,

Wang³

2020

CMAR

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

<p>Combined Therapy Can Improve the Outcomes of Breast Cancer with Isolated Supraclavicular Lymph Node Involvement</p>

Ma¹,

Mao²,

Wang³

2020

CMAR

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“…However, there is no standard of what kind of treatment should be included in multimodal therapy, and surgical treatment of SLNM was not included in the guidelines from the National Comprehensive Cancer Network (NCCN) [ 27 ]. In other studies, surgery of sSLNM was associated with improved survival [ 9 , 10 ], and radical irradiation improved locoregional control but not survival [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, a high risk of residual disease in the supraclavicular fossa has been reported even after aggressive radiotherapy [ 7 ]. Moreover, there are limited studies on surgical extirpation, instead of radiotherapy, incorporated in the multimodal therapy of SLNM [ 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Breast Cancer Patients Who Underwent Selective Neck Dissection for Metachronous Isolated Supraclavicular Nodal Metastasis

Chen

Shen

et al. 2021

Cancers

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We retrospectively enrolled 139 patients who developed metachronous isolated supraclavicular lymph node metastasis (miSLNM) from 8129 consecutive patients who underwent primary surgery between 1990 and 2008 at a single medical center. The median age was 47 years. The median follow-up time from date of primary tumor surgery was 73.1 months, and the median time to the date of neck relapse was 43.9 months in this study. Sixty-one (43.9%) patients underwent selective neck dissection (SND). The 5-year distant metastasis-free survival (DMFS), post-recurrence survival, and overall survival (OS) rates in the SND group were 31.1%, 40.3%, and 68.9%, respectively, whereas those of the no-SND group were 9.7%, 32.9%, and 57.7%, respectively (p = 0.001). No SND and time interval from primary tumor surgery to neck relapse ≤24 months were the only significant risk factors in the multivariate analysis of DMFS (hazard ratio (HR), 1.77; 95% confidence interval (CI), 1.23–2.56; p = 0.002 and HR, 1.76, 95% CI, 1.23–2.52; p = 0.002, respectively) and OS (HR, 1.77; 95% CI, 1.22–2.55; p = 0.003 and HR, 3.54, 95% CI, 2.44–5.16; p < 0.0001, respectively). Multimodal therapy, including neck dissection, significantly improved the DMFS and OS of miSLNM. Survival improvement after miSLNM control by intensive surgical treatment suggests that miSLNM is not distant metastasis.

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“…As the study by Brito et al [31] and our data suggest, treatment of metastases limited only to the neck should be aggressive and include surgical therapy. The proposition of surgical treatment with lymph node dissection offers a feasible solution to the problem, but reports of its successes are contradictory, and large series of controlled trials are still missing [13,32].…”

Section: Discussionmentioning

confidence: 99%

Distribution of Neck Metastases and Survival in Patients with Breast Carcinoma

et al. 2020

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Neck metastases in breast carcinoma are relatively rare and patients show poor survival rates. A controversy exists over whether neck metastases can be treated as distant or loco-regional metastases. The literature concerning the distribution of metastases in the neck is lacking, as well as data about whether metastases in the higher neck regions cause poorer survival than those in the supraclavicular fossa. Methods: Ultrasound investigation with fine-needle biopsy was performed on 41 breast cancer and confirmed neck metastases patients in a 6-year period. We analysed the distribution of neck metastases and patient survival rates using Kaplan-Meier survival curves and Cox regression. Results: The median survival time from the diagnosis of primary disease to that of neck metastases was 21 months. The presence of metastases in sites other than the neck significantly worsened survival, but multiple metastatic sites did not make it significantly worse. The number of nodes and presence of conglomerates did not considerably affect survival. Conclusion: Neck metastases in breast carcinoma can be found not only in the supraclavicular fossa, but elsewhere in the neck as well. Survival of patients with metastases in higher neck regions was shorter, but not very much so. Survival of patients with metastases limited just to the neck was substantially better, therefore early detection and aggressive treatment that could include neck dissection should be considered.

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Aggressive Surgical Excision of Supraclavicular Lymph Node Did Not Improve the Outcomes of Breast Cancer With Supraclavicular Lymph Node Involvement (KROG 16-14)

Cited by 8 publications

References 13 publications

<p>Combined Therapy Can Improve the Outcomes of Breast Cancer with Isolated Supraclavicular Lymph Node Involvement</p>

<p>Combined Therapy Can Improve the Outcomes of Breast Cancer with Isolated Supraclavicular Lymph Node Involvement</p>

Long-Term Outcomes of Breast Cancer Patients Who Underwent Selective Neck Dissection for Metachronous Isolated Supraclavicular Nodal Metastasis

Distribution of Neck Metastases and Survival in Patients with Breast Carcinoma

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