Importance The results of the American College of Surgeons Oncology Group Z (ACOSOG Z) trial were first reported in with a. The American College of Surgeons Oncology Group (ACOSOG) Z trial was a multicenter noninferiority study which enrolled and. ABSTRACT. Introduction. The ACOSOG Z trial has been described as practice-changing. The goal of this study was to determine the.

Author: Gardagor Vudolar
Country: Greece
Language: English (Spanish)
Genre: Relationship
Published (Last): 26 January 2015
Pages: 344
PDF File Size: 2.32 Mb
ePub File Size: 10.75 Mb
ISBN: 192-2-88973-336-5
Downloads: 70541
Price: Free* [*Free Regsitration Required]
Uploader: Mugar

Internal mammary and medial supraclavicular irradiation in breast cancer. The eligibility criteria have been reported. Design, Setting, and Participants: Anderson Cancer Center, Houston. Sign in to customize your interests Sign in to your personal account.

Low-dose oral cyclophosphamide and methotrexate maintenance for hormone receptor-negative early breast cancer: Data quality was ensured by review of data by the Alliance Statistics and Data Center and by the study chairperson following Alliance policies.

Rao and coauthors conducted a review of the literature to summarize evidence regarding the role of axillary interventions surgical and nonsurgical in breast cancer treatment and to review the association of these axillary interventions with recurrence of axillary node metastases, mortality, and morbidity outcomes in patients with breast cancer. The secondary outcome was disease-free survival. In addition, the unplanned analysis showed that no survival differences were observed among patients treated with conventional tangent-field irradiation or nodal-field irradiation.

The year overall survival rate was Patients were randomized to either completion ALND with a minimum of 10 nodes, or to observation. Although the annual rate of distant recurrence after completion of 5 years of endocrine therapy has been reported to range from 0.


In an unplanned analysis of the subset of the patients with detailed radiation records available, those treated with nodal-field irradiation experienced no difference in disease-free survival, overall survival, or locoregional recurrence compared with those who did not receive irradiation. Regional triial irradiation in early-stage breast cancer.

ACOSOG Z – Wiki Journal Club

Kaplan-Meier survival curves for overall survival were compared using the log-rank test for noninferiority. The year disease-free survival was Thus, although nodal irradiation may be added to the management of some patients with node-positive tumors based on an evaluation of their overall risk profile, the routine use of nodal irradiation for all patients with 1 or 2 sentinel node metastases managed with SLND alone may not be justified.

Giuliano AE, et al. Axillary lymph node dissection ALND has historically been a means of maintaining regional control of breast cancer, especially in patients with initial presentation of metastatic nodal disease.

This page was last modified on 6 Septemberat Patterns of axillary surgical care for breast cancer in the era of sentinel lymph node biopsy. Among women with T1 or T2 invasive primary breast cancer, no palpable axillary adenopathy, and 1 or 2 sentinel lymph nodes containing metastases, year overall survival for patients treated with sentinel lymph node dissection alone was noninferior to overall survival for those treated with axillary lymph node dissection.

PubMed Google Scholar Crossref. Hence, the missing data were not associated with outcome.

Due to the significant morbidity of ALND, including paresthesias, lymphedema, seroma, and infection, judicious use of the procedure is important. However increased enrollment was unlikely to lead to a meaningful detection in significance, as the majority of axillary recurrence has been shown to occur in the first few years following surgery, the overall local recurrence rates were too low to be meaningfully changed by increased enrollment 0. Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more.

  ISO 4833-1 PDF

The trial protocol appears in the Supplement. Third-field radiation was prohibited. In a multivariable analysis of overall survival, type of treatment was not significantly associated with overall survival Table 3.

N Engl J Med.


Locoregional recurrence after breast cancer surgery: Axillary lymph node dissection ALNDlong used to identify women with axillary nodal metastases, was replaced as a staging procedure by the less morbid sentinel lymph node dissection SLND. This study has several limitations. As a secondary analysis, known prognostic factors including adjuvant treatment were included in the Cox regression model to generate an adjusted HR for overall survival.

Because the patient characteristics were well balanced, acisog decrease in disease-free survival or overall survival in the SLND alone group would have been anticipated to occur due to an increase in regional recurrences; however, only a single regional recurrence was observed in the SLND alone group with additional follow-up in the ACOSOG Z Alliance trial.

Critical revision of the manuscript for important intellectual content: The proportional hazards assumptions for the Cox models were evaluated acisog Schoenfeld residual plots, and none of the reported models appeared to violate the proportional hazards assumption.

Secondary end points tral been reported.