Measuring the impact of the American College of Surgeons Oncology Group Z0011 trial on breast cancer surgery in a community health system - 13/02/15
, Megan E. Mater, M.D. a, b, Holly L. Sobel, B.S. b, Gregory M. Knoll, M.D. b, c, Leon D. Oostendorp, M.D., F.A.C.S. a, b, d, Marianne K. Melnik, M.D., F.A.C.S. a, b, d, Mathew H. Chung, M.D., F.A.C.S. a, b, dAbstract |
Background |
The American College of Surgeons Oncology Group Z0011 trial has been lauded as practice changing. We sought to identify its impact on breast cancer surgery in the community hospital setting.
Methods |
A retrospective review was performed from 8 community hospitals identifying patients with invasive breast cancer meeting the Z0011 criteria. The primary outcome measures were the rate of completion axillary lymph node dissection (ALND) and performance of intraoperative sentinel lymph node (SLN) analysis over time.
Results |
A total of 1,125 lumpectomies with SLN biopsies were performed with 180 subjects meeting inclusion criteria. Performance of ALND (P < .0001) and intraoperative SLN analysis (P < .0001) declined during each time period. Patients more likely to undergo ALND included those with extracapsular extension (odds ratio [OR] 12.8, 95% confidence interval [CI] 2.5 to 67.1) and those who underwent reoperative surgery (OR 10.8, 95% CI 2.6 to 44.4) or intraoperative SLN analysis (OR 5.1, 95% CI 1.2 to 21.9).
Conclusion |
American College of Surgeons Oncology Group Z0011 trial has been rapidly practice changing in the community hospital setting.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We investigate the effect of ACOSOG Z0011 on breast surgery practice. |
• | We examined factors leading to axillary lymph node dissection. |
• | Intraoperative sentinel lymph node analysis leads to increase in ALND. |
• | ACOSOG Z0011 has been rapidly adopted in community practice. |
Keywords : Breast cancer, Axillary lymph node dissection, Sentinel lymph node biopsy, Frozen section, Z11, Breast conserving surgery
Plan
| The authors declare no conflicts of interest. |
Vol 209 - N° 2
P. 240-245 - février 2015 Retour au numéro
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