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01-05-2019 | Breast Cancer | Clinical trial

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

Authors: 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

Published in: Breast Cancer Research and Treatment | Issue 1/2019

Abstract

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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Title: Retrospectively validating the results of the ACOSOG Z0011 trial in a large Asian Z0011-eligible cohort
Authors: 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
Publication date: 01-05-2019
Publisher: Springer US
Keywords: Breast Cancer
Breast Cancer
Published in: Breast Cancer Research and Treatment / Issue 1/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-019-05157-4

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