دورية أكاديمية
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.
| العنوان: | 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. |
|---|---|
| المؤلفون: | Wetzig N; Wesley Medical Centre, Brisbane, QLD, Australia., Gill PG; Breast, Endocrine & Surgical Oncology Unit, Royal Adelaide Hospital, Adelaide, SA, Australia. grantley.gill@adelaide.edu.au.; Department of Surgery, University of Adelaide, Adelaide, SA, Australia. grantley.gill@adelaide.edu.au., Espinoza D; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia., Mister R; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia., Stockler MR; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia.; Sydney Cancer Centre, Royal Prince Alfred and Concord Hospitals, Sydney, NSW, Australia., Gebski VJ; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia., Ung OA; Department of Medicine, University of Queensland, Brisbane, QLD, Australia.; Centre for Breast Health, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia., Campbell I; Waikato Hospital, Hamilton, New Zealand., Simes J; National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia. |
| المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2017 Apr; Vol. 24 (4), pp. 1064-1070. Date of Electronic Publication: 2016 Nov 15. |
| نوع المنشور: | Comparative Study; Journal Article; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Original Publication: New York, NY : Raven Press, c1994- |
| مواضيع طبية MeSH: | Breast Neoplasms/*pathology , Lymph Node Excision/*adverse effects , Lymphedema/*etiology , Sentinel Lymph Node/*pathology , Sentinel Lymph Node Biopsy/*adverse effects , Upper Extremity/*pathology, Axilla ; Breast Neoplasms/surgery ; Chronic Disease ; Disability Evaluation ; Female ; Follow-Up Studies ; Humans ; Organ Size ; Time Factors ; Tumor Burden ; Weight Gain |
| مستخلص: | Purpose: To determine whether the benefits of sentinel-node-based management (SNBM) over routine axillary clearance (RAC) persisted to 5 years. 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. 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. 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. |
| تواريخ الأحداث: | Date Created: 20161117 Date Completed: 20180223 Latest Revision: 20180223 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1245/s10434-016-5669-2 |
| PMID: | 27848050 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1534-4681 |
|---|---|
| DOI: | 10.1245/s10434-016-5669-2 |