Table 3.
Summary of therapeutic relevance of c/pN divergence and resulting changes of adjuvant and primary radiation therapy
| cN | → pN | No. of patients | Up/downstaging | Effect of cN → pN change on adjuvant treatment | Hypothetical effect of cN → pN change on primary radiotherapy treatment |
|---|---|---|---|---|---|
| cN0 | pN1 | 1 | Up | Higher radiation dose ipsilateral side | Higher radiation dose |
| pN2b | 1 | Up | Higher radiation dose ipsilateral side | Higher radiation dose | |
| pN2c | 2 | Up | Higher radiation dose | Higher radiation dose | |
| pN3b | 1 | Up | Higher radiation dose, additional Chemotherapy | Higher radiation dose, additional Chemotherapy | |
| cN1 | pN2a | 3 | Up | None | None |
| cN2b | pN0 | 1 | Down | Lower radiation dose ipsilateral side | Lower radiation dose |
| pN2c | 2 | Up | Higher radiation dose contralateral side | Higher radiation dose contralateral side | |
| cN2c | pN0 | 1 | Down | Lower radiation dose | Lower radiation dose |
| pN2b | 2 | Down | Lower radiation dose | Lower radiation dose contralateral side | |
| pN3b | 1 | Up | Higher radiation dose | Higher radiation dose, additional Chemotherapy | |
| cN3 | pN2a | 1 | Down | Lower radiation dose | Lower radiation dose |
| pN2b | 1 | Down | None | Lower radiation dose |
Hypothetical effects in case of a primary radiotherapy treatment approach were assessed via a retrospective virtual tumor board