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Retrospectively validating the results of the ACOSOG Z0011 trial in a large Asian Z0011-eligible cohort

 Jiwoong Jung  ;  Wonshik Han  ;  Eun Sook Lee  ;  So-Youn Jung  ;  Jai Hong Han  ;  Dong-Young Noh  ;  Yumi Kim  ;  Hee Jun Choi  ;  Jeong Eon Lee  ;  Seok Jin Nam  ;  Jong Won Lee  ;  Hee Jeong Kim  ;  Eunhae Um  ;  Joo Heung Kim  ;  Seho Park  ;  Young Up Cho 
 BREAST CANCER RESEARCH AND TREATMENT, Vol.175(1) : 203-215, 2019 
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Axillary lymph node dissection ; Breast cancer ; Sentinel lymph node biopsy
PURPOSE: The Z0011 trial demonstrated that axillary dissection (ALND) could be omitted during breast-conserving therapy for cT1-2N0 breast cancers with 1-2 metastatic SLNs. However, that result has not been validated in a larger cohort and the significance of the small number of SLNs remains unclear. This study aimed to validate the Z0011 results within an Asian Z0011-eligible cohort and determine whether the number of sentinel lymph nodes (SLNs) influenced the Z0011-based outcomes. METHODS: Data from Asian patients who fulfilled the Z0011 criteria were collected from five hospitals. Disease recurrence (DR) was compared between patients who underwent ALND or SLN dissection (SLND) alone. Propensity-score matching was performed to reduce the effects of potential selection biases. RESULTS: During 2010-2016, 1750 Asian patients had 1-2 SLN metastases and fulfilled the Z0011 criteria. These patients included 707 cases treated using SLND alone (40%) and 967 patients with ≤ 2 SLNs (55%). Ninety-five patients (5.4%) experienced DR at a median interval of 50 months, although the rates of DR were similar in the ALND and SLND groups. The adjusted hazard ratios for DR after ALND omission were 0.95 (95% CI 0.55-1.64) among the entire cohort and 0.83 (95% CI 0.34-2.03) among patients with ≤ 2 SLNs. CONCLUSIONS: In this Asian Z0011-eligible cohort, ALND omission did not increase risk of DR, even among patients with ≤ 2 SLNs. Therefore, the Z0011 strategy might be safely applied in Asia, and a small number of SLNs did not significantly influence this strategy.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Cho, Young Up(조영업) ORCID logo https://orcid.org/0000-0003-2936-410X
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