Sentinel-Lymph-Node-Based Management or Routine Axillary Clearance? Five-Year Outcomes of the RACS Sentinel Node Biopsy Versus Axillary Clearance (SNAC) 1 Trial: Assessment and Incidence of True Lymphedema.
Identifieur interne : 000517 ( PubMed/Curation ); précédent : 000516; suivant : 000518Sentinel-Lymph-Node-Based Management or Routine Axillary Clearance? Five-Year Outcomes of the RACS Sentinel Node Biopsy Versus Axillary Clearance (SNAC) 1 Trial: Assessment and Incidence of True Lymphedema.
Auteurs : Neil Wetzig [Australie] ; Peter Grantley Gill [Australie] ; David Espinoza [Australie] ; Rebecca Mister [Australie] ; Martin R. Stockler [Australie] ; Val J. Gebski [Australie] ; Owen A. Ung [Australie] ; Ian Campbell [Nouvelle-Zélande] ; John Simes [Australie]Source :
- Annals of surgical oncology [ 1534-4681 ] ; 2017.
Abstract
To determine whether the benefits of sentinel-node-based management (SNBM) over routine axillary clearance (RAC) persisted to 5 years.
DOI: 10.1245/s10434-016-5669-2
PubMed: 27848050
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<series><title level="j">Annals of surgical oncology</title>
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<front><div type="abstract" xml:lang="en">To determine whether the benefits of sentinel-node-based management (SNBM) over routine axillary clearance (RAC) persisted to 5 years.</div>
</front>
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<Month>11</Month>
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<Title>Annals of surgical oncology</Title>
<ISOAbbreviation>Ann. Surg. Oncol.</ISOAbbreviation>
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<ArticleTitle>Sentinel-Lymph-Node-Based Management or Routine Axillary Clearance? Five-Year Outcomes of the RACS Sentinel Node Biopsy Versus Axillary Clearance (SNAC) 1 Trial: Assessment and Incidence of True Lymphedema.</ArticleTitle>
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<Abstract><AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">To determine whether the benefits of sentinel-node-based management (SNBM) over routine axillary clearance (RAC) persisted to 5 years.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">A total of 1088 women with breast cancer less than 3 cm in diameter and clinically negative axillary nodes were randomized to SNBM with axillary clearance if the sentinel node was positive or RAC preceded by sentinel-node biopsy. The outcomes were: (1) objectively measured change in the volume of the operated and contralateral nonoperated arms; (2) the proportion with an increase in arm volume <15%; and (3) subjectively assessed arm morbidity for the domains swelling, symptoms, dysfunction, and disability. Assessments were performed at 1 and 6 months after surgery and then annually.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Limb volume increased progressively in the operated and nonoperated arms for 2 years and persisted unchanged to year 5, accompanied by weight gain. Correction by change in the nonoperated arm showed a mean volume increase of 70 mL in the RAC group and 26 mL in the SNBM group (P < 0.001) at 5 years. Only 28 patients (3.3%) had a corrected increase >15% from baseline (RAC 5.0% vs. SNBM 1.7%). Significant predictors were surgery type (RAC vs. SNBM), obesity, diabetes, palpable tumor, and weight gain exceeding 10% of baseline value.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Subjective assessments revealed persisting patient concerns about swelling and symptoms but not overall disability at 5 years. Subjective scores were only moderately correlated with volume increase. SNAC1 has demonstrated that objective morbidity and subjective morbidity persist for 5 years after surgery and that SNBM significantly lowers the risk of both.</AbstractText>
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<AffiliationInfo><Affiliation>Sydney Cancer Centre, Royal Prince Alfred and Concord Hospitals, Sydney, NSW, Australia.</Affiliation>
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