首页 | 本学科首页   官方微博 | 高级检索  
     


The Exportability of the ACOSOG Z0011 Criteria for Omitting Axillary Lymph Node Dissection After Positive Sentinel Lymph Node Biopsy Findings: A Multicenter Study
Authors:Yann Delpech MD  Alexandre Bricou MD  Ruben Lousquy MD  Delphine Hudry MD  Clémentine Jankowski MD  Claire Willecocq MD  Anne Thoury MD  Catherine Loustalot MD  Charles Coutant MD   PhD  Emmanuel Barranger MD
Affiliation:1. Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
2. Department of Gynecology and Obstetrics, Lariboisiere Hospital/AP-HP, The University Denis Diderot, Paris, France
3. Department of Gynecology and Obstetrics, Jean Verdier Hospital/AP-HP, The University Paris Nord, Bondy, France
4. Department of Surgical Oncology, Georges Francois Leclerc Cancer Center, The University of Bourgogne, Dijon, France
Abstract:

Purpose

To determine the exportability of the criteria defined by the American College of Surgeons Oncology Group Z0011 trial for selecting patients who are eligible for omitting completion axillary lymph node dissection (cALND) after a positive sentinel lymph node (SLN) biopsy result and to investigate whether not following the Z0011 criteria might affect patient outcomes.

Methods

From a multicenter database, we selected 188 patients with positive SLNs and then excluded patients with positive SLNs on immunohistochemistry only. We retrospectively applied the Z0011 criteria and grouped the patients as eligible or ineligible for omitting cALND. The eligible group was compared with the cohort included in the Z0011 trial and with the ineligible group. Kaplan–Meier survival curves were calculated for each group, and univariate analyses assessed associations between the groups and clinicopathological variables.

Results

The final analysis involved 125 patients with positive SLNs. Eighty-seven patients (69.6 %) were potentially eligible for omitting cALND. The estrogen receptor status, T stage, grade, and number of positive non-SLNs were not statistically different between the eligible group and the Z0011 cohort. The ineligible group had significantly more positive non-SLNs (P = 0.01) and a lower 5-year overall survival rate than the eligible group (P < 0.001).

Conclusions

The similarity of clinical characteristics between the Z0011 trial cohort and our eligible group confirms the exportability of these criteria to another population. The worse prognosis of patients who did not meet the Z0011 criteria suggests prudence before disregarding or enlarging broadening the indications for omitting cALND.
Keywords:
本文献已被 SpringerLink 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号