Cargando…

One-Step Nucleic Acid Amplification System in Comparison to the Intraoperative Frozen Section and Definitive Histological Examination Among Breast Cancer Patients: A Retrospective Survival Study

SIMPLE SUMMARY: Implementing intraoperative assessment of sentinel lymph nodes by one-step nucleic acid amplification in early breast cancer can reduce the surgical burden to the patient and the costs to the health system. However, only limited data are available in terms of long-term disease-free s...

Descripción completa

Detalles Bibliográficos
Autores principales: Bertozzi, Serena, Londero, Ambrogio P., Bulfoni, Michela, Seriau, Luca, Agakiza, Diane, Pasqualucci, Alberto, Andretta, Michela, Orsaria, Maria, Mariuzzi, Laura, Cedolini, Carla
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9158526/
https://www.ncbi.nlm.nih.gov/pubmed/35664761
http://dx.doi.org/10.3389/fonc.2022.847858
_version_ 1784718856327004160
author Bertozzi, Serena
Londero, Ambrogio P.
Bulfoni, Michela
Seriau, Luca
Agakiza, Diane
Pasqualucci, Alberto
Andretta, Michela
Orsaria, Maria
Mariuzzi, Laura
Cedolini, Carla
author_facet Bertozzi, Serena
Londero, Ambrogio P.
Bulfoni, Michela
Seriau, Luca
Agakiza, Diane
Pasqualucci, Alberto
Andretta, Michela
Orsaria, Maria
Mariuzzi, Laura
Cedolini, Carla
author_sort Bertozzi, Serena
collection PubMed
description SIMPLE SUMMARY: Implementing intraoperative assessment of sentinel lymph nodes by one-step nucleic acid amplification in early breast cancer can reduce the surgical burden to the patient and the costs to the health system. However, only limited data are available in terms of long-term disease-free survival and overall survival. Therefore, this study aims to compare disease-free survival and overall survival between one-step nucleic acid amplification, frozen section, and definitive histology. These results could impact the healthcare community, adding further proof to the body of evidence supporting the broader adoption of this innovative technology that enables a safe reduction in patient surgical burden and healthcare costs. BACKGROUND: The one-step nucleic acid amplification (OSNA) system is a novel molecular technique, which consents to quick intraoperative detection of sentinel lymph node metastases by the amplification of cytokeratin 19 mRNA. Our study aims to evaluate the OSNA method in comparison with frozen section (FS) and definitive histological examination of the sentinel lymph node biopsy among early breast cancer patients considering disease-free survival (DFS) and overall survival (OS). METHODS: In this study, we included all women who underwent sentinel lymph node biopsy (SLNB) for breast cancers classified as TNM stage I and II in our center between January 2005 and January 2017, and the follow-up was collected up to January 2019. We divided patients among three groups based on SLNB evaluation: definitive histological examination, intra-operative FS, or OSNA. RESULTS: We included 2412 SLNBs: 727 by definitive histological examination, 697 by FS, and 988 by OSNA. Isolated tumor cells were found in 2.32% of cases, micrometastasis in 9.12%, and macrometastases in 13.64%. Surgical procedure duration was significantly shorter in OSNA than in FS (42.1 minutes ±5.1 vs. 70.1 minutes ±10.5, p <0.05). No significant differences have been observed among the three groups regarding OS, DSF, cumulative local, or distant metastases. In particular 5-year DFS was 96.38% in definitive histology (95% C.I. 95.02-97.75%), 96.37% in FS (95% C.I. 94.98-97.78%), and 96.51% in OSNA group (95% C.I. 95.32-97.72%). CONCLUSIONS: No difference in OS and DFS was found comparing OSNA, FS, and definitive histology. Furthermore, reduced operative time was found in the OSNA group.
format Online
Article
Text
id pubmed-9158526
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-91585262022-06-02 One-Step Nucleic Acid Amplification System in Comparison to the Intraoperative Frozen Section and Definitive Histological Examination Among Breast Cancer Patients: A Retrospective Survival Study Bertozzi, Serena Londero, Ambrogio P. Bulfoni, Michela Seriau, Luca Agakiza, Diane Pasqualucci, Alberto Andretta, Michela Orsaria, Maria Mariuzzi, Laura Cedolini, Carla Front Oncol Oncology SIMPLE SUMMARY: Implementing intraoperative assessment of sentinel lymph nodes by one-step nucleic acid amplification in early breast cancer can reduce the surgical burden to the patient and the costs to the health system. However, only limited data are available in terms of long-term disease-free survival and overall survival. Therefore, this study aims to compare disease-free survival and overall survival between one-step nucleic acid amplification, frozen section, and definitive histology. These results could impact the healthcare community, adding further proof to the body of evidence supporting the broader adoption of this innovative technology that enables a safe reduction in patient surgical burden and healthcare costs. BACKGROUND: The one-step nucleic acid amplification (OSNA) system is a novel molecular technique, which consents to quick intraoperative detection of sentinel lymph node metastases by the amplification of cytokeratin 19 mRNA. Our study aims to evaluate the OSNA method in comparison with frozen section (FS) and definitive histological examination of the sentinel lymph node biopsy among early breast cancer patients considering disease-free survival (DFS) and overall survival (OS). METHODS: In this study, we included all women who underwent sentinel lymph node biopsy (SLNB) for breast cancers classified as TNM stage I and II in our center between January 2005 and January 2017, and the follow-up was collected up to January 2019. We divided patients among three groups based on SLNB evaluation: definitive histological examination, intra-operative FS, or OSNA. RESULTS: We included 2412 SLNBs: 727 by definitive histological examination, 697 by FS, and 988 by OSNA. Isolated tumor cells were found in 2.32% of cases, micrometastasis in 9.12%, and macrometastases in 13.64%. Surgical procedure duration was significantly shorter in OSNA than in FS (42.1 minutes ±5.1 vs. 70.1 minutes ±10.5, p <0.05). No significant differences have been observed among the three groups regarding OS, DSF, cumulative local, or distant metastases. In particular 5-year DFS was 96.38% in definitive histology (95% C.I. 95.02-97.75%), 96.37% in FS (95% C.I. 94.98-97.78%), and 96.51% in OSNA group (95% C.I. 95.32-97.72%). CONCLUSIONS: No difference in OS and DFS was found comparing OSNA, FS, and definitive histology. Furthermore, reduced operative time was found in the OSNA group. Frontiers Media S.A. 2022-05-18 /pmc/articles/PMC9158526/ /pubmed/35664761 http://dx.doi.org/10.3389/fonc.2022.847858 Text en Copyright © 2022 Bertozzi, Londero, Bulfoni, Seriau, Agakiza, Pasqualucci, Andretta, Orsaria, Mariuzzi and Cedolini https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Bertozzi, Serena
Londero, Ambrogio P.
Bulfoni, Michela
Seriau, Luca
Agakiza, Diane
Pasqualucci, Alberto
Andretta, Michela
Orsaria, Maria
Mariuzzi, Laura
Cedolini, Carla
One-Step Nucleic Acid Amplification System in Comparison to the Intraoperative Frozen Section and Definitive Histological Examination Among Breast Cancer Patients: A Retrospective Survival Study
title One-Step Nucleic Acid Amplification System in Comparison to the Intraoperative Frozen Section and Definitive Histological Examination Among Breast Cancer Patients: A Retrospective Survival Study
title_full One-Step Nucleic Acid Amplification System in Comparison to the Intraoperative Frozen Section and Definitive Histological Examination Among Breast Cancer Patients: A Retrospective Survival Study
title_fullStr One-Step Nucleic Acid Amplification System in Comparison to the Intraoperative Frozen Section and Definitive Histological Examination Among Breast Cancer Patients: A Retrospective Survival Study
title_full_unstemmed One-Step Nucleic Acid Amplification System in Comparison to the Intraoperative Frozen Section and Definitive Histological Examination Among Breast Cancer Patients: A Retrospective Survival Study
title_short One-Step Nucleic Acid Amplification System in Comparison to the Intraoperative Frozen Section and Definitive Histological Examination Among Breast Cancer Patients: A Retrospective Survival Study
title_sort one-step nucleic acid amplification system in comparison to the intraoperative frozen section and definitive histological examination among breast cancer patients: a retrospective survival study
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9158526/
https://www.ncbi.nlm.nih.gov/pubmed/35664761
http://dx.doi.org/10.3389/fonc.2022.847858
work_keys_str_mv AT bertozziserena onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy
AT londeroambrogiop onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy
AT bulfonimichela onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy
AT seriauluca onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy
AT agakizadiane onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy
AT pasqualuccialberto onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy
AT andrettamichela onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy
AT orsariamaria onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy
AT mariuzzilaura onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy
AT cedolinicarla onestepnucleicacidamplificationsystemincomparisontotheintraoperativefrozensectionanddefinitivehistologicalexaminationamongbreastcancerpatientsaretrospectivesurvivalstudy