Relationship between Arm Morbidity and Patient-Reported Outcomes Following Surgery in Women with Node-Negative Breast Cancer: NSABP Protocol B-32
Identifieur interne : 002013 ( Pmc/Checkpoint ); précédent : 002012; suivant : 002014Relationship between Arm Morbidity and Patient-Reported Outcomes Following Surgery in Women with Node-Negative Breast Cancer: NSABP Protocol B-32
Auteurs : Jacek A. Kopec [États-Unis, Canada] ; Linda H. Colangelo [États-Unis] ; Stephanie R. Land [États-Unis] ; Thomas B. Julian [États-Unis] ; Ann M. Brown [États-Unis] ; Stewart J. Anderson [États-Unis] ; David N. Krag [États-Unis] ; Takamaru Ashikaga [États-Unis] ; Joseph P. Costantino [États-Unis] ; Norman Wolmark [États-Unis] ; Patricia A. Ganz [États-Unis]Source :
- The journal of supportive oncology [ 1544-6794 ] ; 2013.
Abstract
The impact of arm morbidity following breast cancer surgery on patient-observed changes in daily functioning and health-related quality of life (HRQoL) have not been well-studied.
To examine the association of objective measures such as range of motion (ROM) and lymphedema, with patient-reported outcomes (PROs) in the arm and breast, upper extremity function, activities, and HRQoL.
The National Surgical Adjuvant Breast and Bowel Project Protocol B-32 was a randomized trial comparing sentinel node resection (SNR) with axillary dissection (AD) in women with node-negative breast cancer. ROM and arm volume were measured objectively. PROs included symptoms; arm function; limitations in social, recreational, occupational, and other regular activities; and a global index of HRQoL. Statistical methods included cross-tabulations and multivariable linear regression models.
In all, 744 women provided at least 1 postsurgery assessment. About one-third of the patients experienced arm mobility restrictions. A similar number of patients avoided the use of the arm 6 months after surgery. Limitations in work and other regular activities were reported by about a quarter of the patients. In this multivariable analysis, arm mobility and sensory neuropathy were predictors of patient-reported arm function and overall HRQoL. Predictors for activity limitations also included side of surgery (dominant vs nondominant). Edema was not significant after adjustment for sensory neuropathy and ROM.
Arm mobility and edema were measured simultaneously only once during the follow-up (6 months).
Clinical measures of sensory neuropathy and restrictions in arm mobility following breast cancer surgery are associated with self-reported limitations in activity and reductions in overall HRQoL.
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DOI: 10.1016/j.suponc.2012.05.003
PubMed: 22951047
PubMed Central: 4131548
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Kopec</name><affiliation wicri:level="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Population and Public Health, University of British Columbia, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Colangelo, Linda H" sort="Colangelo, Linda H" uniqKey="Colangelo L" first="Linda H." last="Colangelo">Linda H. 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Kopec</name><affiliation wicri:level="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Population and Public Health, University of British Columbia, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Colangelo, Linda H" sort="Colangelo, Linda H" uniqKey="Colangelo L" first="Linda H." last="Colangelo">Linda H. Colangelo</name><affiliation wicri:level="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh</wicri:cityArea></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="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh</wicri:cityArea></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="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Allegheny General Hospital, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Allegheny General Hospital, Pittsburgh</wicri:cityArea></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="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh</wicri:cityArea></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="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Krag, David N" sort="Krag, David N" uniqKey="Krag D" first="David N." last="Krag">David N. Krag</name><affiliation wicri:level="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A5">University of Vermont College of Medicine and Breast Care Center, United Health Care, Burlington, VT</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Vermont</region></placeName><wicri:cityArea>University of Vermont College of Medicine and Breast Care Center, United Health Care, Burlington</wicri:cityArea></affiliation></author><author><name sortKey="Ashikaga, Takamaru" sort="Ashikaga, Takamaru" uniqKey="Ashikaga T" first="Takamaru" last="Ashikaga">Takamaru Ashikaga</name><affiliation wicri:level="2"><nlm:aff id="A5">University of Vermont College of Medicine and Breast Care Center, United Health Care, Burlington, VT</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Vermont</region></placeName><wicri:cityArea>University of Vermont College of Medicine and Breast Care Center, United Health Care, Burlington</wicri:cityArea></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="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Wolmark, Norman" sort="Wolmark, Norman" uniqKey="Wolmark N" first="Norman" last="Wolmark">Norman Wolmark</name><affiliation wicri:level="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Allegheny General Hospital, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Allegheny General Hospital, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Ganz, Patricia A" sort="Ganz, Patricia A" uniqKey="Ganz P" first="Patricia A." last="Ganz">Patricia A. Ganz</name><affiliation wicri:level="2"><nlm:aff id="A1">National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="A6">Schools of Medicine and Public Health and the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Schools of Medicine and Public Health and the Jonsson Comprehensive Cancer Center, University of California, Los Angeles</wicri:cityArea></affiliation></author></analytic><series><title level="j">The journal of supportive oncology</title><idno type="ISSN">1544-6794</idno><idno type="eISSN">1879-596X</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P2">The impact of arm morbidity following breast cancer surgery on patient-observed changes in daily functioning and health-related quality of life (HRQoL) have not been well-studied.</p></sec><sec id="S2"><title>Objective</title><p id="P3">To examine the association of objective measures such as range of motion (ROM) and lymphedema, with patient-reported outcomes (PROs) in the arm and breast, upper extremity function, activities, and HRQoL.</p></sec><sec id="S3"><title>Methods</title><p id="P4">The National Surgical Adjuvant Breast and Bowel Project Protocol B-32 was a randomized trial comparing sentinel node resection (SNR) with axillary dissection (AD) in women with node-negative breast cancer. ROM and arm volume were measured objectively. PROs included symptoms; arm function; limitations in social, recreational, occupational, and other regular activities; and a global index of HRQoL. Statistical methods included cross-tabulations and multivariable linear regression models.</p></sec><sec id="S4"><title>Results</title><p id="P5">In all, 744 women provided at least 1 postsurgery assessment. About one-third of the patients experienced arm mobility restrictions. A similar number of patients avoided the use of the arm 6 months after surgery. Limitations in work and other regular activities were reported by about a quarter of the patients. In this multivariable analysis, arm mobility and sensory neuropathy were predictors of patient-reported arm function and overall HRQoL. Predictors for activity limitations also included side of surgery (dominant vs nondominant). Edema was not significant after adjustment for sensory neuropathy and ROM.</p></sec><sec id="S5"><title>Limitations</title><p id="P6">Arm mobility and edema were measured simultaneously only once during the follow-up (6 months).</p></sec><sec id="S6"><title>Conclusion</title><p id="P7">Clinical measures of sensory neuropathy and restrictions in arm mobility following breast cancer surgery are associated with self-reported limitations in activity and reductions in overall HRQoL.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101181305</journal-id><journal-id journal-id-type="pubmed-jr-id">31984</journal-id><journal-id journal-id-type="nlm-ta">J Support Oncol</journal-id><journal-id journal-id-type="iso-abbrev">J Support Oncol</journal-id><journal-title-group><journal-title>The journal of supportive oncology</journal-title></journal-title-group><issn pub-type="ppub">1544-6794</issn><issn pub-type="epub">1879-596X</issn></journal-meta><article-meta><article-id pub-id-type="pmid">22951047</article-id><article-id pub-id-type="pmc">4131548</article-id><article-id pub-id-type="doi">10.1016/j.suponc.2012.05.003</article-id><article-id pub-id-type="manuscript">NIHMS404029</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Relationship between Arm Morbidity and Patient-Reported Outcomes Following Surgery in Women with Node-Negative Breast Cancer: NSABP Protocol B-32</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kopec</surname><given-names>Jacek A.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A2">b</xref></contrib><contrib contrib-type="author"><name><surname>Colangelo</surname><given-names>Linda H.</given-names></name><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Land</surname><given-names>Stephanie R.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Julian</surname><given-names>Thomas B.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Brown</surname><given-names>Ann M.</given-names></name><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A3">c</xref><xref rid="FN2" ref-type="author-notes">†</xref></contrib><contrib contrib-type="author"><name><surname>Anderson</surname><given-names>Stewart J.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Krag</surname><given-names>David N.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Ashikaga</surname><given-names>Takamaru</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A5">e</xref></contrib><contrib contrib-type="author"><name><surname>Costantino</surname><given-names>Joseph P.</given-names></name><degrees>DrPH</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A3">c</xref></contrib><contrib contrib-type="author"><name><surname>Wolmark</surname><given-names>Norman</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A4">d</xref></contrib><contrib contrib-type="author"><name><surname>Ganz</surname><given-names>Patricia A.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">a</xref><xref ref-type="aff" rid="A6">f</xref></contrib></contrib-group><aff id="A1"><label>a</label>National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistical Center, Pittsburgh, PA</aff><aff id="A2"><label>b</label>School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada</aff><aff id="A3"><label>c</label>Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA</aff><aff id="A4"><label>d</label>Allegheny General Hospital, Pittsburgh, PA</aff><aff id="A5"><label>e</label>University of Vermont College of Medicine and Breast Care Center, United Health Care, Burlington, VT</aff><aff id="A6"><label>f</label>Schools of Medicine and Public Health and the Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA</aff><author-notes><corresp id="FN1">Correspondence / Reprints to: Jacek A. Kopec, MD, PhD, School of Population and Public Health, University of British Columbia, Arthritis Research Centre of Canada, 895 10<sup>th</sup> Ave West, British Columbia, Canada V5Z 1L7, Ph: 604-871-4588; Fx: 604-879-3791, <email>jkopec@arthritisresearch.ca</email></corresp><fn id="FN2"><label>†</label><p>Deceased</p></fn></author-notes><pub-date pub-type="nihms-submitted"><day>28</day><month>9</month><year>2012</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2013</year></pub-date><pub-date pub-type="pmc-release"><day>13</day><month>8</month><year>2014</year></pub-date><volume>11</volume><issue>1</issue><fpage>22</fpage><lpage>30</lpage><pmc-comment>elocation-id from pubmed: 10.1016/j.suponc.2012.05.003</pmc-comment>
<permissions><copyright-statement>©2012 Elsevier Inc. All rights reserved.</copyright-statement><copyright-year>2012</copyright-year></permissions><abstract><sec id="S1"><title>Background</title><p id="P2">The impact of arm morbidity following breast cancer surgery on patient-observed changes in daily functioning and health-related quality of life (HRQoL) have not been well-studied.</p></sec><sec id="S2"><title>Objective</title><p id="P3">To examine the association of objective measures such as range of motion (ROM) and lymphedema, with patient-reported outcomes (PROs) in the arm and breast, upper extremity function, activities, and HRQoL.</p></sec><sec id="S3"><title>Methods</title><p id="P4">The National Surgical Adjuvant Breast and Bowel Project Protocol B-32 was a randomized trial comparing sentinel node resection (SNR) with axillary dissection (AD) in women with node-negative breast cancer. ROM and arm volume were measured objectively. PROs included symptoms; arm function; limitations in social, recreational, occupational, and other regular activities; and a global index of HRQoL. Statistical methods included cross-tabulations and multivariable linear regression models.</p></sec><sec id="S4"><title>Results</title><p id="P5">In all, 744 women provided at least 1 postsurgery assessment. About one-third of the patients experienced arm mobility restrictions. A similar number of patients avoided the use of the arm 6 months after surgery. Limitations in work and other regular activities were reported by about a quarter of the patients. In this multivariable analysis, arm mobility and sensory neuropathy were predictors of patient-reported arm function and overall HRQoL. Predictors for activity limitations also included side of surgery (dominant vs nondominant). Edema was not significant after adjustment for sensory neuropathy and ROM.</p></sec><sec id="S5"><title>Limitations</title><p id="P6">Arm mobility and edema were measured simultaneously only once during the follow-up (6 months).</p></sec><sec id="S6"><title>Conclusion</title><p id="P7">Clinical measures of sensory neuropathy and restrictions in arm mobility following breast cancer surgery are associated with self-reported limitations in activity and reductions in overall HRQoL.</p></sec></abstract><kwd-group><kwd>Breast Cancer</kwd><kwd>Axillary Dissection</kwd><kwd>Sentinel Node Resection</kwd><kwd>Arm Morbidity</kwd><kwd>Patient-Reported Outcomes</kwd><kwd>Quality of Life</kwd></kwd-group></article-meta></front></pmc><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Californie</li><li>Pennsylvanie</li><li>Vermont</li></region></list><tree><country name="États-Unis"><region name="Pennsylvanie"><name sortKey="Kopec, Jacek A" sort="Kopec, Jacek A" uniqKey="Kopec J" first="Jacek A." last="Kopec">Jacek A. Kopec</name></region><name sortKey="Anderson, Stewart J" sort="Anderson, Stewart J" uniqKey="Anderson S" first="Stewart J." last="Anderson">Stewart J. Anderson</name><name sortKey="Anderson, Stewart J" sort="Anderson, Stewart J" uniqKey="Anderson S" first="Stewart J." last="Anderson">Stewart J. Anderson</name><name sortKey="Ashikaga, Takamaru" sort="Ashikaga, Takamaru" uniqKey="Ashikaga T" first="Takamaru" last="Ashikaga">Takamaru Ashikaga</name><name sortKey="Brown, Ann M" sort="Brown, Ann M" uniqKey="Brown A" first="Ann M." last="Brown">Ann M. Brown</name><name sortKey="Brown, Ann M" sort="Brown, Ann M" uniqKey="Brown A" first="Ann M." last="Brown">Ann M. Brown</name><name sortKey="Colangelo, Linda H" sort="Colangelo, Linda H" uniqKey="Colangelo L" first="Linda H." last="Colangelo">Linda H. Colangelo</name><name sortKey="Colangelo, Linda H" sort="Colangelo, Linda H" uniqKey="Colangelo L" first="Linda H." last="Colangelo">Linda H. Colangelo</name><name sortKey="Costantino, Joseph P" sort="Costantino, Joseph P" uniqKey="Costantino J" first="Joseph P." last="Costantino">Joseph P. Costantino</name><name sortKey="Costantino, Joseph P" sort="Costantino, Joseph P" uniqKey="Costantino J" first="Joseph P." last="Costantino">Joseph P. Costantino</name><name sortKey="Ganz, Patricia A" sort="Ganz, Patricia A" uniqKey="Ganz P" first="Patricia A." last="Ganz">Patricia A. Ganz</name><name sortKey="Ganz, Patricia A" sort="Ganz, Patricia A" uniqKey="Ganz P" first="Patricia A." last="Ganz">Patricia A. Ganz</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="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="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><country name="Canada"><noRegion><name sortKey="Kopec, Jacek A" sort="Kopec, Jacek A" uniqKey="Kopec J" first="Jacek A." last="Kopec">Jacek A. Kopec</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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