Importance The results of the American College of Surgeons Oncology Group Z (ACOSOG Z) trial were first reported in with a. The American College of Surgeons Oncology Group (ACOSOG) Z trial was a multicenter noninferiority study which enrolled and. ABSTRACT. Introduction. The ACOSOG Z trial has been described as practice-changing. The goal of this study was to determine the.

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Operation had no significant effect on overall survival with respect to estrogen receptor and progesterone receptor status. All patients provided written informed consent.

The primary outcome was overall survival with a noninferiority hazard ratio HR margin of 1. Among women with T1 or T2 invasive primary breast cancer, no palpable axillary adenopathy, and 1 or 2 sentinel lymph nodes containing metastases, year overall survival for patients treated with sentinel lymph node acozog alone was noninferior to overall survival for those treated with axillary lymph node dissection.

All secondary analyses were tested for differences. Views Read View source View history. These findings do not support routine use of axillary lymph node dissection in this patient population based on year outcomes.

The secondary outcome was disease-free survival. Adjuvant systemic therapy was delivered to women Data quality was ensured by review of data by the Alliance Statistics and Data Center and by the study chairperson following Alliance policies. The long-term outcome of this study provides additional support that axillary dissection is not necessary for long-term disease control and survival for patients triial positive sentinel nodes, even for those with generally late-recurring hormone receptor—positive tumors.

For more than years, the extent of breast cancer surgery was based on the Halstedian concept of breast cancer as a locoregional disease that spread via the lymphatic system and was cured by resection.


Due to the significant morbidity of ALND, including paresthesias, lymphedema, seroma, and infection, judicious use of the procedure is important. Longer follow-up was necessary acoosg the majority of the patients had estrogen receptor-positive tumors that may recur later in the disease course the ACOSOG is now part of the Alliance for Clinical Trials in Oncology. Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account.

Low-dose oral cyclophosphamide and methotrexate maintenance for hormone receptor-negative early breast cancer: Neither the Alliance nor the National Cancer Institute had the right to veto the submission of the manuscript. Even with follow-up extended to a median of 9.

An independent acsog of radiation fields in a subset of participants demonstrated no between-group difference in the use of high tangents, nodal irradiation, or no irradiation; Dr Ballman also reported receiving grant support from the National Cancer Institute during the conduct of the study.

The secondary outcome was disease-free survival.

A population-based study of the effects of a regional guideline for completion axillary lymph node dissection on axillary surgery in patients with breast cancer. The Journal of the American Medical Association.

Create a free personal account to download free article PDFs, sign up for alerts, and more. The majority of women received radiation therapy women [ Patients who withdrew consent for use of their information were omitted from the analyses. Usable articles Oncology Surgery. The HR for overall survival 0z011 for adjuvant therapy chemotherapy, endocrine therapy, radiation, or a combination of these 3 and age for the SLND alone group compared with the ALND group was 0.

Purchase access Subscribe now. Consistent with this finding, the incremental decreases in disease-free survival 3. Secondary end points have been reported.

Aocsog revision of the manuscript for important intellectual content: Enrollment began in May with a planned accrual of patients and closed in December due to a lower than expected event rate.


The primary end point was overall survival as a measure of noninferiority of no further axillary-specified interventions SLND alone group compared with the ALND group. Create a personal account to register for email alerts with links to free full-text articles.


Previously reported in [4]. Sign in to customize your interests Sign in to your personal account. Disease-free survival was analyzed with a log-rank analysis using Kaplan-Meier aclsog and unadjusted and multivariable Cox regression analyses. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Acquisition, analysis, or interpretation of data: Eur J Surg Oncol.

ACOSOG Z – Wiki Journal Club

In an adjusted analysis, well documented prognostic factors such as age, hormone receptor status, tumor size, and the use of adjuvant therapy but not elimination of ALND were associated with overall survival. The trial closed early because of low accrual rates and fewer than anticipated events. acksog

In a multivariable analysis of overall survival, type of treatment was not significantly associated with overall survival Table 3. The stability of these results over time is important because patients with hormone receptor—positive breast cancer, who comprise the majority of study participants and the s0011 of breast cancer patients in the United States, are known to be at prolonged risk for disease recurrence.

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