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.

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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 acozog too low to be meaningfully changed by increased enrollment 0.

Dr Hansen also reported receiving speakers fees from Genentech and Genomic Health. Treatment of regional lymph nodes in breast cancer-evidence in favor of radiation therapy. The National Cancer Trixl had a role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

The eligibility criteria have been reported. The study and design end points have been described elsewhere. Adult women with histologically confirmed invasive breast carcinoma clinically 5 cm or less in size, no palpable adenopathy, and with sentinel nodes containing metastatic breast cancer detected without immunohistochemical stains were eligible for participation.

As a secondary analysis, known prognostic factors including adjuvant treatment were included in the Cox regression model to trizl an adjusted HR for overall survival. The median total number of nodes containing metastases in both groups was 1 IQR, Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: Axillary Node Interventions in Breast Cancer.


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

Enrollment of patients in 4 years with a minimum follow-up period of 5 years was initially planned. 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 triaal axillary node metastases, mortality, and morbidity outcomes in patients with breast cancer.

ACOSOG Z – Wiki Journal Club

J Am Coll Surg. Purchase access Subscribe to JN Learning for one year. Even with follow-up extended to a median of 9.

The primary study end point was overall survival, which was trixl as the time from randomization until death from any cause. The year disease-free survival was 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.

Navigation menu Personal tools Create account Log in. Views Read View source View history. The American College of Surgeons Oncology Group ACOSOG Z trial was a multicenter noninferiority study which enrolled and randomized patients with breast cancer, T disease, clinically negative axillary nodes, 1 or 2 macrometastatic nodes on SLNB, tria a plan for breast conserving therapy consisting of lumpectomy and whole-breast radiation.

Longer follow-up was necessary because the majority of the patients had estrogen receptor—positive tumors that may recur later in the disease course the ACOSOG is now part of the Alliance for Clinical Trials in Oncology.

No other disclosures were reported. At a median follow-up of 9. An exploratory analysis was conducted to determine the effect of treatment SLND alone vs ALND on overall survival for patients with hormone receptor—positive tumors. Sign in to save your search Sign in to your personal account. Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts.


The study database was frozen on September 29, The study was terminated before target enrollment of women because the observed mortality was lower than anticipated. Potential impact of application of Z derived criteria to omit axillary lymph node dissection in node positive breast cancer patients.

The secondary outcome was disease-free survival. Sign in to access your subscriptions Sign in to your personal account.

Because the patient characteristics were well balanced, any 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 acosig with additional follow-up in the ACOSOG Z Alliance trial.

Third-field radiation was prohibited.


Disease-free survival, which was defined as the time from randomization to death or first breast cancer recurrence, was a secondary end point along with morbidity and locoregional recurrence. Back to top Article Information. Main Outcomes and Measures: Operation had no 0z011 effect on overall survival with respect to estrogen receptor and progesterone receptor status.

Sign in to customize your interests Sign in to your personal account. Eligible patients were women with clinical T1 or T2 invasive breast cancer, no palpable axillary adenopathy, and 1 or 2 sentinel lymph nodes containing metastases.

Our website uses cookies to enhance your experience. Breast Cancer Res Treat. For more than years, the extent of breast cancer surgery was based on the Halstedian concept of breast cancer as a locoregional disease that spread via the lymphatic system and was cured by resection.

Eur J Surg Oncol. Follow-up was planned for 10 years.