Locoregional Recurrence After Sentinel Lymph Node Dissection With or Without Axillary Dissection in Patients With Sentinel Lymph Node Metastases: Long-term Follow-up From the American College of Surgeons Oncology Group (Alliance) ACOSOG Z0011 Randomized Trial
| Autor: | Karla V. Ballman, Peter D. Beitsch, Peter W. Blumencranz, Pat Whitworth, Armando E. Giuliano, A. Marilyn Leitch, Monica Morrow, Linda M. McCall, Kelly K. Hunt, Sukamal Saha |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Oncology
Adult medicine.medical_specialty medicine.medical_treatment Sentinel lymph node Breast Neoplasms 030230 surgery Mastectomy Segmental Article law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Medicine Humans Prospective Studies Prospective cohort study Aged Aged 80 and over business.industry Axillary Lymph Node Dissection Middle Aged Surgery Axilla Dissection medicine.anatomical_structure 030220 oncology & carcinogenesis Lymphatic Metastasis Lymph Node Excision Female Lymph Neoplasm Recurrence Local Sentinel Lymph Node business Mastectomy Follow-Up Studies |
| Zdroj: | Annals of surgery. 264(3) |
| ISSN: | 1528-1140 |
| Popis: | The early results of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial demonstrated no difference in locoregional recurrence for patients with positive sentinel lymph nodes (SLNs) randomized either to axillary lymph node dissection (ALND) or sentinel lymph node dissection (SLND) alone. We now report long-term locoregional recurrence results.ACOSOG Z0011 prospectively examined overall survival of patients with SLN metastases undergoing breast-conserving therapy randomized to undergo ALND after SLND or no further axillary specific treatment. Locoregional recurrence was prospectively evaluated and compared between the groups.Four hundred forty-six patients were randomized to SLND alone and 445 to SLND and ALND. Both groups were similar with respect to age, Bloom-Richardson score, Estrogen Receptor status, adjuvant systemic therapy, histology, and tumor size. Patients randomized to ALND had a median of 17 axillary nodes removed compared with a median of only 2 SLNs removed with SLND alone (P0.001). ALND, as expected, also removed more positive lymph nodes (P0.001). At a median follow-up of 9.25 years, there was no statistically significant difference in local recurrence-free survival (P = 0.13). The cumulative incidence of nodal recurrences at 10 years was 0.5% in the ALND arm and 1.5% in the SLND alone arm (P = 0.28). Ten-year cumulative locoregional recurrence was 6.2% with ALND and 5.3% with SLND alone (P = 0.36).Despite the potential for residual axillary disease after SLND, SLND without ALND offers excellent regional control for selected patients with early metastatic breast cancer treated with breast-conserving therapy and adjuvant systemic therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|