Applicability of the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial results in invasive lobular carcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1103-1103
Author(s):  
Jun Wang ◽  
Elizabeth Ann Mittendorf ◽  
Aysegul A. Sahin ◽  
Min Yi ◽  
Abigail Suzanne Caudle ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Invasive Lobular Carcinoma ◽  
Lobular Carcinoma ◽  
Node Dissection ◽  
Oncology Group ◽  
Eligibility Criteria ◽  
Acosog Z0011 ◽  
American College Of Surgeons ◽  
Z0011 Trial

1103 Background: The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial demonstrated that, for patients with clinical T1-T2, N0 breast cancer and one or two positive sentinel lymph nodes undergoing breast conserving therapy, there was no difference in local-regional recurrence (LRR), disease-free survival or overall survival (OS) between patients who underwent sentinel lymph node dissection (SLND) alone or completion axillary lymph node dissection (ALND). However, there were a limited number of invasive lobular carcinoma (ILC) participants (7%) in the study. In addition, it is known that ILC has a different pattern of metastases, frequently presenting as small foci requiring immunohistochemistry for detection. Together, these considerations raise concern regarding the applicability of the ACOSOG Z0011 data to patients with ILC. Methods: Patients with ILC who met the ACOSOG Z0011 eligibility criteria were identified from the Surveillance, Epidemiology, and End Results database (1998-2009). Patients were evaluated based on the extent of axillary surgery: SLND alone or ALND. Clinicaloutcomes of the two groups were compared. Results: At a median follow-up of 71 months, there were no LRRs in the SLND arm, and only 4 (0.45%) in the ALND arm. There were no differences in OS or disease-specific survival between the two groups. Conclusions: Omission of completion ALND is appropriate in patients with ILC who fulfill the ACOSOG Z0011 eligibility criteria.

scholarly journals Size of Extranodal Extension on Sentinel Lymph Node Dissection in the American College of Surgeons Oncology Group Z0011 Trial Era

JAMA Surgery ◽  
2015 ◽  
Vol 150 (12) ◽  
pp. 1141 ◽  
Author(s):  
Audrey H. Choi ◽  
Summer Blount ◽  
Mia N. Perez ◽  
Carlos E. Chavez de Paz ◽  
Samuel A. Rodriguez ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Node Dissection ◽  
Sentinel Lymph Node Dissection ◽  
Node Dissection ◽  
Oncology Group ◽  
Extranodal Extension ◽  
American College Of Surgeons ◽  
Z0011 Trial

scholarly journals Is completion axillary lymph node dissection necessary in patients who are underrepresented in the ACOSOG Z0011 trial?

2018 ◽  
Vol 3 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Brian J. Gebhardt ◽  
Joel Thomas ◽  
Zachary D. Horne ◽  
Colin E. Champ ◽  
Daniel J. Farrugia ◽  
...  
Keyword(s):  
Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Acosog Z0011 ◽  
Z0011 Trial

Surgical Complications Associated With Sentinel Lymph Node Dissection (SLND) Plus Axillary Lymph Node Dissection Compared With SLND Alone in the American College of Surgeons Oncology Group Trial Z0011

2007 ◽  
Vol 25 (24) ◽  
pp. 3657-3663 ◽  
Author(s):  
Anthony Lucci ◽  
Linda Mackie McCall ◽  
Peter D. Beitsch ◽  
Patrick W. Whitworth ◽  
Douglas S. Reintgen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Wound Infections ◽  
Node Dissection ◽  
Oncology Group ◽  
American College Of Surgeons ◽  
Group Trial

PurposeThe American College of Surgeons Oncology Group trial Z0011 was a prospective, randomized, multicenter trial comparing overall survival between patients with positive sentinel lymph nodes (SLNs) who did and did not undergo axillary lymph node dissection (ALND). The current study compares complications associated with SLN dissection (SLND) plus ALND, versus SLND alone.Patients and MethodsFrom May 1999 to December 2004, 891 patients were randomly assigned to SLND + ALND (n = 445) or SLND alone (n = 446). Information on wound infection, axillary seroma, paresthesia, brachial plexus injury (BPI), and lymphedema was available for 821 patients.ResultsAdverse surgical effects were reported in 70% (278 of 399) of patients after SLND + ALND and 25% (103 of 411) after SLND alone (P ≤ .001). Patients in the SLND + ALND group had more wound infections (P ≤ .0016), seromas (P ≤ .0001), and paresthesias (P ≤ .0001) than those in the SLND-alone group. At 1 year, lymphedema was reported subjectively by 13% (37 of 288) of patients after SLND + ALND and 2% (six of 268) after SLND alone (P ≤ .0001). The difference between the two groups' lymphedema, assessed by arm measurements at 30 days (P = .36), 6 months (P = .22), and 1 year (P = .078), although close to the cutoff for significance at 1 year, was not significant. BPIs occurred in less than 1% of patients.ConclusionIn trial Z0011, the use of SLND + ALND resulted in more wound infections, axillary seromas, and paresthesias than SLND alone. Lymphedema was more common after SLND + ALND but was significantly different only by subjective report. The use of SLND alone resulted in fewer complications.

scholarly journals Potential impact of application to the Z0011 trial on the omission of axillary lymph node dissection in women undergoing sentinel node biopsy: a retrospective cohort study

2020 ◽  
Author(s):  
Julia Yoriko Shinzato ◽  
Katia Piton Serra ◽  
Caroline Eugeni ◽  
César Cabello ◽  
Cassio Cardoso-Filho ◽  
...  
Keyword(s):  
Lymph Node ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Acosog Z0011 ◽  
Node Biopsy ◽  
Number Of Patients ◽  
Z0011 Trial

Abstract Objectives: To evaluate the number of patients with early-stage breast cancer who could benefit from the omission of axillary surgery following the application of ACOSOG Z0011 trial criteria.Results: A total of 384 patients underwent breast-conserving surgery and sentinel lymph node biopsy. Of the total number of patients, 86 women underwent axillary lymph node dissection for metastatic sentinel lymph nodes. One patient underwent axillary node dissection due to a suspicious SLN intra-operatively. Among these patients, 82/87 (94.3%) had one to two involved sentinel lymph nodes and met criteria for the ACOSOG Z0011 trial with the omission of axillary lymph node dissection. Among the 82 eligible women, there were only 13 cases (15.9%) of lymphovascular invasion and 62 cases (75.6%) of tumors measuring up to 2cm in diameter (T1). The high rate of patients who met criteria for the ACOSOG Z0011 trial may be explained by the large number of patients with disease of a favorable prognosis. ACOSOG Z0011 trial criteria can be applied to a select group of SLN-positive patients, reducing the costs and morbidities of breast cancer surgery.

scholarly journals Potential impact of application to the Z0011 trial on the omission of axillary lymph node dissection in women undergoing sentinel node biopsy: a retrospective cohort study

2020 ◽  
Author(s):  
Julia Yoriko Shinzato ◽  
Katia Piton Serra ◽  
Caroline Eugeni ◽  
Cesar Cabello ◽  
Cassio Cardoso Filho ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Axillary Lymph Node Dissection ◽  
Lymph Node Dissection ◽  
Axillary Lymph Node ◽  
Sentinel Lymph Nodes ◽  
Axillary Lymph ◽  
Node Dissection ◽  
Acosog Z0011 ◽  
Z0011 Trial

Abstract Background To evaluate the number of patients with early-stage breast cancer, undergoing axillary lymph node dissection for metastatic sentinel lymph nodes, who could benefit from the omission of axillary surgery following the application of ACOSOG Z0011 trial criteria. Methods A retrospective cohort study conducted in the Women’s Hospital of the State University of Campinas. The study population included 384 women diagnosed with early-stage invasive breast cancer, clinically negative axilla, treated with breast-conserving surgery and sentinel lymph node biopsy, radiation therapy, chemotherapy and/or endocrine therapy, from January 2005 to December 2010. ACOSOG Z0011 trial criteria were applied to this population and statistical analysis was carried out to make a comparison between populations. Results A total of 384 patients underwent breast-conserving surgery and sentinel lymph node biopsy. Of the total number of patients, 86 women underwent axillary lymph node dissection for metastatic sentinel lymph nodes. One patient underwent axillary node dissection due to a suspicious SLN intra-operatively. Among these patients, 82/87 (94.3%) had one to two involved sentinel lymph nodes and met criteria for the ACOSOG Z0011 trial with the omission of axillary lymph node dissection. Among the 82 eligible women, there were only 13 cases (15.9%) of lymphovascular invasion and 62 cases (75.6%) of tumors measuring up to 2cm in diameter (T1). Conclusions When eligibility for ACOSOG Z0011 trial criteria was retrospectively exported to our study population, 94.3% of the patients with one to two positive sentinel lymph nodes would benefit from the omission of axillary lymph node dissection. The high rate in our study may be explained by the large number of patients with tumors up to 2.0 cm in size and the small rate of lymphovascular invasion, which are indicative of a favorable prognosis.

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