Morbidity Results from the NSABP B-32 Trial Comparing Sentinel Lymph Node Dissection versus Axillary Dissection
Identifieur interne : 003C71 ( Ncbi/Checkpoint ); précédent : 003C70; suivant : 003C72Morbidity Results from the NSABP B-32 Trial Comparing Sentinel Lymph Node Dissection versus Axillary Dissection
Auteurs : Takamaru Ashikaga [États-Unis] ; David N. Krag [États-Unis] ; Stephanie R. Land [États-Unis] ; Thomas B. Julian [États-Unis] ; Stewart J. Anderson [États-Unis] ; Ann M. Brown [États-Unis] ; Joan M. Skelly [États-Unis] ; Seth P. Harlow [États-Unis] ; Donald L. Weaver [États-Unis] ; Eleftherios P. Mamounas [États-Unis] ; Joseph P. Costantino [États-Unis] ; Norman Wolmark [États-Unis]Source :
- Journal of surgical oncology [ 0022-4790 ] ; 2010.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Aisselle, Amplitude articulaire (physiologie), Articulation glénohumérale (physiopathologie), Biopsie de noeud lymphatique sentinelle, Bras (physiopathologie), Femelle, Humains, Hypoesthésie (physiopathologie), Hypoesthésie (étiologie), Lymphadénectomie (), Lymphadénectomie (effets indésirables), Lymphoedème (physiopathologie), Lymphoedème (étiologie), Paresthésie (physiopathologie), Paresthésie (étiologie), Tumeurs du sein (anatomopathologie), Études de suivi, Études prospectives.
- MESH :
- anatomopathologie : Tumeurs du sein.
- effets indésirables : Lymphadénectomie.
- physiologie : Amplitude articulaire.
- physiopathologie : Articulation glénohumérale, Bras, Hypoesthésie, Lymphoedème, Paresthésie.
- étiologie : Hypoesthésie, Lymphoedème, Paresthésie.
- Adulte d'âge moyen, Aisselle, Biopsie de noeud lymphatique sentinelle, Femelle, Humains, Lymphadénectomie, Études de suivi, Études prospectives.
English descriptors
- KwdEn :
- Arm (physiopathology), Axilla, Breast Neoplasms (pathology), Female, Follow-Up Studies, Humans, Hypesthesia (etiology), Hypesthesia (physiopathology), Lymph Node Excision (adverse effects), Lymph Node Excision (methods), Lymphedema (etiology), Lymphedema (physiopathology), Middle Aged, Paresthesia (etiology), Paresthesia (physiopathology), Prospective Studies, Range of Motion, Articular (physiology), Sentinel Lymph Node Biopsy, Shoulder Joint (physiopathology).
- MESH :
- adverse effects : Lymph Node Excision.
- etiology : Hypesthesia, Lymphedema, Paresthesia.
- methods : Lymph Node Excision.
- pathology : Breast Neoplasms.
- physiology : Range of Motion, Articular.
- physiopathology : Arm, Hypesthesia, Lymphedema, Paresthesia, Shoulder Joint.
- Axilla, Female, Follow-Up Studies, Humans, Middle Aged, Prospective Studies, Sentinel Lymph Node Biopsy.
Abstract
Three year post-surgical morbidity levels were compared between patients with negative sentinel lymph node dissection alone (SLND) and those with negative sentinel node dissection and negative axillary lymph node dissection (ALND) in the NSABP B-32 trial.
A total of 1975 ALND and 2008 SLND node negative breast cancer patients had shoulder range of motion and arm volumes assessed along with self reports of arm tingling and numbness. Relative shoulder abduction deficits and relative arm volume differences between ipsilateral and contralateral arms were calculated.
Shoulder abduction deficits ≥ 10% peaked at one week for the ALND (75%) and SLND (41%) groups. Arm volume differences ≥ 10% at 36 months were evident for the ALND (14%) and SLND (8%) groups. Numbness and tingling peaked at 6 months for the ALND (49%, 23%) and SLND (15%, 10%) groups. Logistic regression correlates of residual morbidity included treatment group, age, handedness, tumor size, systemic chemotherapy and radiation to the axilla.
Although residual morbidity for both treatment groups was evident, the results of the NSABP B-32 study indicate the superiority of the SLND compared to the ALND treatment approach relative to post-surgical morbidity outcomes over a three year follow-up period.
Url:
DOI: 10.1002/jso.21535
PubMed: 20648579
PubMed Central: 3072246
Affiliations:
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Krag</name><affiliation wicri:level="1"><nlm:aff id="A1">University of Vermont College of Medicine, Burlington, VT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Vermont College of Medicine, Burlington, VT</wicri:regionArea><wicri:noRegion>VT</wicri:noRegion></affiliation></author><author><name sortKey="Land, Stephanie R" sort="Land, Stephanie R" uniqKey="Land S" first="Stephanie R" last="Land">Stephanie R. Land</name><affiliation wicri:level="1"><nlm:aff id="A2">National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA</wicri:regionArea><wicri:noRegion>PA</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Julian, Thomas B" sort="Julian, Thomas B" uniqKey="Julian T" first="Thomas B" last="Julian">Thomas B. Julian</name><affiliation wicri:level="1"><nlm:aff id="A2">National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA</wicri:regionArea><wicri:noRegion>PA</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Anderson, Stewart J" sort="Anderson, Stewart J" uniqKey="Anderson S" first="Stewart J" last="Anderson">Stewart J. Anderson</name><affiliation wicri:level="4"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Brown, Ann M" sort="Brown, Ann M" uniqKey="Brown A" first="Ann M" last="Brown">Ann M. Brown</name><affiliation wicri:level="4"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Skelly, Joan M" sort="Skelly, Joan M" uniqKey="Skelly J" first="Joan M" last="Skelly">Joan M. Skelly</name><affiliation wicri:level="1"><nlm:aff id="A1">University of Vermont College of Medicine, Burlington, VT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Vermont College of Medicine, Burlington, VT</wicri:regionArea><wicri:noRegion>VT</wicri:noRegion></affiliation></author><author><name sortKey="Harlow, Seth P" sort="Harlow, Seth P" uniqKey="Harlow S" first="Seth P" last="Harlow">Seth P. Harlow</name><affiliation wicri:level="1"><nlm:aff id="A1">University of Vermont College of Medicine, Burlington, VT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Vermont College of Medicine, Burlington, VT</wicri:regionArea><wicri:noRegion>VT</wicri:noRegion></affiliation></author><author><name sortKey="Weaver, Donald L" sort="Weaver, Donald L" uniqKey="Weaver D" first="Donald L" last="Weaver">Donald L. Weaver</name><affiliation wicri:level="1"><nlm:aff id="A1">University of Vermont College of Medicine, Burlington, VT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Vermont College of Medicine, Burlington, VT</wicri:regionArea><wicri:noRegion>VT</wicri:noRegion></affiliation></author><author><name sortKey="Mamounas, Eleftherios P" sort="Mamounas, Eleftherios P" uniqKey="Mamounas E" first="Eleftherios P" last="Mamounas">Eleftherios P. Mamounas</name><affiliation wicri:level="1"><nlm:aff id="A4">Aultman Health Foundation, Canton, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Aultman Health Foundation, Canton, OH</wicri:regionArea><wicri:noRegion>OH</wicri:noRegion></affiliation></author><author><name sortKey="Costantino, Joseph P" sort="Costantino, Joseph P" uniqKey="Costantino J" first="Joseph P" last="Costantino">Joseph P. Costantino</name><affiliation wicri:level="4"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</wicri:regionArea><orgName type="university">Université de Pittsburgh</orgName><placeName><settlement type="city">Pittsburgh</settlement><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Wolmark, Norman" sort="Wolmark, Norman" uniqKey="Wolmark N" first="Norman" last="Wolmark">Norman Wolmark</name><affiliation wicri:level="1"><nlm:aff id="A2">National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA</wicri:regionArea><wicri:noRegion>PA</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A5">Allegheny General Hospital, Pittsburgh, PA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Allegheny General Hospital, Pittsburgh, PA</wicri:regionArea><wicri:noRegion>PA</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of surgical oncology</title><idno type="ISSN">0022-4790</idno><idno type="eISSN">1096-9098</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm (physiopathology)</term><term>Axilla</term><term>Breast Neoplasms (pathology)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Hypesthesia (etiology)</term><term>Hypesthesia (physiopathology)</term><term>Lymph Node Excision (adverse effects)</term><term>Lymph Node Excision (methods)</term><term>Lymphedema (etiology)</term><term>Lymphedema (physiopathology)</term><term>Middle Aged</term><term>Paresthesia (etiology)</term><term>Paresthesia (physiopathology)</term><term>Prospective Studies</term><term>Range of Motion, Articular (physiology)</term><term>Sentinel Lymph Node Biopsy</term><term>Shoulder Joint (physiopathology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Amplitude articulaire (physiologie)</term><term>Articulation glénohumérale (physiopathologie)</term><term>Biopsie de noeud lymphatique sentinelle</term><term>Bras (physiopathologie)</term><term>Femelle</term><term>Humains</term><term>Hypoesthésie (physiopathologie)</term><term>Hypoesthésie (étiologie)</term><term>Lymphadénectomie ()</term><term>Lymphadénectomie (effets indésirables)</term><term>Lymphoedème (physiopathologie)</term><term>Lymphoedème (étiologie)</term><term>Paresthésie (physiopathologie)</term><term>Paresthésie (étiologie)</term><term>Tumeurs du sein (anatomopathologie)</term><term>Études de suivi</term><term>Études prospectives</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Lymphadénectomie</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Hypesthesia</term><term>Lymphedema</term><term>Paresthesia</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Amplitude articulaire</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Range of Motion, Articular</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Articulation glénohumérale</term><term>Bras</term><term>Hypoesthésie</term><term>Lymphoedème</term><term>Paresthésie</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Arm</term><term>Hypesthesia</term><term>Lymphedema</term><term>Paresthesia</term><term>Shoulder Joint</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Hypoesthésie</term><term>Lymphoedème</term><term>Paresthésie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Axilla</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Middle Aged</term><term>Prospective Studies</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Biopsie de noeud lymphatique sentinelle</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Études de suivi</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background and Objectives</title><p id="P1">Three year post-surgical morbidity levels were compared between patients with negative sentinel lymph node dissection alone (SLND) and those with negative sentinel node dissection and negative axillary lymph node dissection (ALND) in the NSABP B-32 trial.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">A total of 1975 ALND and 2008 SLND node negative breast cancer patients had shoulder range of motion and arm volumes assessed along with self reports of arm tingling and numbness. Relative shoulder abduction deficits and relative arm volume differences between ipsilateral and contralateral arms were calculated.</p></sec><sec id="S3"><title>Results</title><p id="P3">Shoulder abduction deficits ≥ 10% peaked at one week for the ALND (75%) and SLND (41%) groups. Arm volume differences ≥ 10% at 36 months were evident for the ALND (14%) and SLND (8%) groups. Numbness and tingling peaked at 6 months for the ALND (49%, 23%) and SLND (15%, 10%) groups. Logistic regression correlates of residual morbidity included treatment group, age, handedness, tumor size, systemic chemotherapy and radiation to the axilla.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Although residual morbidity for both treatment groups was evident, the results of the NSABP B-32 study indicate the superiority of the SLND compared to the ALND treatment approach relative to post-surgical morbidity outcomes over a three year follow-up period.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Pennsylvanie</li></region><settlement><li>Pittsburgh</li></settlement><orgName><li>Université de Pittsburgh</li></orgName></list><tree><country name="États-Unis"><noRegion><name sortKey="Ashikaga, Takamaru" sort="Ashikaga, Takamaru" uniqKey="Ashikaga T" first="Takamaru" last="Ashikaga">Takamaru Ashikaga</name></noRegion><name sortKey="Anderson, Stewart J" sort="Anderson, Stewart J" uniqKey="Anderson S" first="Stewart J" last="Anderson">Stewart J. Anderson</name><name sortKey="Brown, Ann M" sort="Brown, Ann M" uniqKey="Brown A" first="Ann M" last="Brown">Ann M. Brown</name><name sortKey="Costantino, Joseph P" sort="Costantino, Joseph P" uniqKey="Costantino J" first="Joseph P" last="Costantino">Joseph P. Costantino</name><name sortKey="Harlow, Seth P" sort="Harlow, Seth P" uniqKey="Harlow S" first="Seth P" last="Harlow">Seth P. Harlow</name><name sortKey="Julian, Thomas B" sort="Julian, Thomas B" uniqKey="Julian T" first="Thomas B" last="Julian">Thomas B. Julian</name><name sortKey="Julian, Thomas B" sort="Julian, Thomas B" uniqKey="Julian T" first="Thomas B" last="Julian">Thomas B. Julian</name><name sortKey="Krag, David N" sort="Krag, David N" uniqKey="Krag D" first="David N" last="Krag">David N. Krag</name><name sortKey="Land, Stephanie R" sort="Land, Stephanie R" uniqKey="Land S" first="Stephanie R" last="Land">Stephanie R. Land</name><name sortKey="Land, Stephanie R" sort="Land, Stephanie R" uniqKey="Land S" first="Stephanie R" last="Land">Stephanie R. Land</name><name sortKey="Mamounas, Eleftherios P" sort="Mamounas, Eleftherios P" uniqKey="Mamounas E" first="Eleftherios P" last="Mamounas">Eleftherios P. Mamounas</name><name sortKey="Skelly, Joan M" sort="Skelly, Joan M" uniqKey="Skelly J" first="Joan M" last="Skelly">Joan M. Skelly</name><name sortKey="Weaver, Donald L" sort="Weaver, Donald L" uniqKey="Weaver D" first="Donald L" last="Weaver">Donald L. Weaver</name><name sortKey="Wolmark, Norman" sort="Wolmark, Norman" uniqKey="Wolmark N" first="Norman" last="Wolmark">Norman Wolmark</name><name sortKey="Wolmark, Norman" sort="Wolmark, Norman" uniqKey="Wolmark N" first="Norman" last="Wolmark">Norman Wolmark</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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