The biology behind the american college of surgeons oncology group z0011 trial
Menée à partir de données portant sur 208 patientes atteintes d'un cancer du sein de stade T1N0 ou T2N0 avec envahissement d'un ou deux ganglions sentinelles (durée médiane de suivi : 60 mois), cette étude évalue l'association entre la taille de l'envahissement extra-ganglionnaire à la biopsie des ganglions sentinelles et les taux de récidive ou de survie
The American College of Surgeons Oncology Group Z0011 trial has established a low rate of locoregional recurrence with the omission of axillary lymph node dissection (ALND), with the adjunct of improved systemic therapy as well as radiation therapy in patients with minimal nodal disease. Gross extranodal disease was excluded but microscopic extranodal extension (ENE) was not evaluated. The trial did, however, include lymphovascular invasion with 35.2% in the sentinel lymph node biopsy arm vs 40.6% in the axillary lymph node dissection arm; like ENE, lymphovascular invasion is a poor prognostic indicator.2
JAMA Surgery , commentaire, 2014