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Open AccessArticle

Validating the ACOSOG Z0011 Trial Result: A Population-Based Study Using the SEER Database

1
Department of Surgery, Seoul Medical Center, Seoul 02053, Korea
2
Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, Korea
3
Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, Korea
4
Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, Korea
5
Department of Surgery, Seoul National University College of Medicine, Seoul 03080, Korea
6
Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul 07061, Korea
*
Author to whom correspondence should be addressed.
These authors have contributed equally to write the manuscript.
Cancers 2020, 12(4), 950; https://doi.org/10.3390/cancers12040950
Received: 29 February 2020 / Revised: 8 April 2020 / Accepted: 9 April 2020 / Published: 11 April 2020
The Z0011 trial demonstrated that axillary lymph node dissection (ALND) could be omitted in spite of 1–2 metastatic sentinel lymph nodes. This study aimed to validate the results on a population-based database. The Surveillance, Epidemiology, and End Results (SEER) database was searched for patients comparable to the Z0011 participants. The type of axillary surgery was estimated using the total number of examined axillary lymph nodes (ALNs). Breast cancer-specific mortality (BCSM) was compared between patients with ≥10 ALNs (the sentinel lymph node dissection (SLND) and ALND group, or “SLND + ALND group”) and patients with one or two ALNs (the “SLND group”). During 2010–2015, the SEER database included 7077 and 6620 patients categorized in the SLND group and the SLND + ALND group, respectively. Death was observed for 515 patients (7.3%) in the SLND group and 589 patients (8.9%) in the SLND + ALND group based on a median follow-up of 41 months. After propensity-score matching, the adjusted hazard ratio for BCSM in the SLND group (vs. the SLND + ALND group) was 1.038 (95% confidence interval: 0.798–1.350). Regardless of the SLND criteria, the outcomes were not significantly different between the two groups. This retrospective cohort study of Z0011-comparable patients revealed that ALND could be omitted based on the Z0011 strategy, even among patients with ≤2 dissected ALNs. View Full-Text
Keywords: axillary lymph node dissection; breast cancer; sentinel lymph node biopsy axillary lymph node dissection; breast cancer; sentinel lymph node biopsy
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MDPI and ACS Style

Jung, J.; Kim, B.H.; Kim, J.; Oh, S.; Kim, S.-j.; Lim, C.-S.; Choi, I.S.; Hwang, K.-T. Validating the ACOSOG Z0011 Trial Result: A Population-Based Study Using the SEER Database. Cancers 2020, 12, 950.

AMA Style

Jung J, Kim BH, Kim J, Oh S, Kim S-j, Lim C-S, Choi IS, Hwang K-T. Validating the ACOSOG Z0011 Trial Result: A Population-Based Study Using the SEER Database. Cancers. 2020; 12(4):950.

Chicago/Turabian Style

Jung, Jiwoong; Kim, Byoung H.; Kim, Jongjin; Oh, Sohee; Kim, Su-jin; Lim, Chang-Sup; Choi, In S.; Hwang, Ki-Tae. 2020. "Validating the ACOSOG Z0011 Trial Result: A Population-Based Study Using the SEER Database" Cancers 12, no. 4: 950.

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