Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes? A systematic review and meta-analysis
Objective: To compare the efficacy of axillary radiotherapy (ART) with that of completion axillary lymph node dissection (cALND) in clinically node-negative breast cancer patients with a positive sentinel lymph node. Methods: A literature search was performed in PubMed, EMBASE and Cochrane Library b...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-03-01
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| Series: | Chronic Diseases and Translational Medicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2095882X1630069X |
| _version_ | 1811227934487216128 |
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| author | Min Zhao Wei-Guang Liu Lei Zhang Zi-Ning Jin Zhan Li Cheng Liu Dong-Bao Li Ying Ma Jing-Wen Zhang Feng Jin Bo Chen |
| author_facet | Min Zhao Wei-Guang Liu Lei Zhang Zi-Ning Jin Zhan Li Cheng Liu Dong-Bao Li Ying Ma Jing-Wen Zhang Feng Jin Bo Chen |
| author_sort | Min Zhao |
| collection | DOAJ |
| description | Objective: To compare the efficacy of axillary radiotherapy (ART) with that of completion axillary lymph node dissection (cALND) in clinically node-negative breast cancer patients with a positive sentinel lymph node. Methods: A literature search was performed in PubMed, EMBASE and Cochrane Library by using the search terms âbreast cancerâ, âsentinel lymph node biopsyâ, âaxillary radiotherapyâ or âregional node irradiationâ for articles published between 2004 and 2016. Only randomized controlled trials that included patients with positive sentinel nodes were included in the meta-analysis. Results: Two randomized controlled trials and three retrospective studies were identified. The reported overall survival rate (hazard ratio [HR]Â =Â 1.09, 95% confidence interval [CI]: 0.75â1.43, PÂ =Â 0.365), disease-free survival rate (HRÂ =Â 1.01, 95% CI: 0.58â1.45, PÂ =Â 0.144), and axillary recurrence rate (1.2% and 0.4%, and 1.3% and 0.8%, respectively) were similar in both groups. The absence of knowledge on the extent of nodal involvement in the ART group appeared to have no major impact on the administration of adjuvant systemic therapy. Conclusions: ART is not inferior to cALND in the patients with clinically node-negative breast cancer who had a positive sentinel lymph node. Information obtained by using cALND after SLNB may have no major impact on the administration of adjuvant systemic therapy. Keywords: Breast cancer, Sentinel lymph node biopsy, Completion axillary lymph node dissection, Axillary radiotherapy, Meta-analysis |
| first_indexed | 2024-04-12T09:50:03Z |
| format | Article |
| id | doaj.art-bdd32f31bcf14ad39505e45553e5ad46 |
| institution | Directory Open Access Journal |
| issn | 2095-882X |
| language | English |
| last_indexed | 2024-04-12T09:50:03Z |
| publishDate | 2017-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Chronic Diseases and Translational Medicine |
| spelling | doaj.art-bdd32f31bcf14ad39505e45553e5ad462022-12-22T03:37:50ZengWileyChronic Diseases and Translational Medicine2095-882X2017-03-01314150Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes? A systematic review and meta-analysisMin Zhao0Wei-Guang Liu1Lei Zhang2Zi-Ning Jin3Zhan Li4Cheng Liu5Dong-Bao Li6Ying Ma7Jing-Wen Zhang8Feng Jin9Bo Chen10Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaDepartment of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaDepartment of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaDepartment of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaDepartment of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaDepartment of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaDepartment of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaDepartment of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaDepartment of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaDepartment of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaCorresponding author.; Department of Breast Surgery, The First Hospital of China Medical University, Shenyang, Liaoning 110001, ChinaObjective: To compare the efficacy of axillary radiotherapy (ART) with that of completion axillary lymph node dissection (cALND) in clinically node-negative breast cancer patients with a positive sentinel lymph node. Methods: A literature search was performed in PubMed, EMBASE and Cochrane Library by using the search terms âbreast cancerâ, âsentinel lymph node biopsyâ, âaxillary radiotherapyâ or âregional node irradiationâ for articles published between 2004 and 2016. Only randomized controlled trials that included patients with positive sentinel nodes were included in the meta-analysis. Results: Two randomized controlled trials and three retrospective studies were identified. The reported overall survival rate (hazard ratio [HR]Â =Â 1.09, 95% confidence interval [CI]: 0.75â1.43, PÂ =Â 0.365), disease-free survival rate (HRÂ =Â 1.01, 95% CI: 0.58â1.45, PÂ =Â 0.144), and axillary recurrence rate (1.2% and 0.4%, and 1.3% and 0.8%, respectively) were similar in both groups. The absence of knowledge on the extent of nodal involvement in the ART group appeared to have no major impact on the administration of adjuvant systemic therapy. Conclusions: ART is not inferior to cALND in the patients with clinically node-negative breast cancer who had a positive sentinel lymph node. Information obtained by using cALND after SLNB may have no major impact on the administration of adjuvant systemic therapy. Keywords: Breast cancer, Sentinel lymph node biopsy, Completion axillary lymph node dissection, Axillary radiotherapy, Meta-analysishttp://www.sciencedirect.com/science/article/pii/S2095882X1630069X |
| spellingShingle | Min Zhao Wei-Guang Liu Lei Zhang Zi-Ning Jin Zhan Li Cheng Liu Dong-Bao Li Ying Ma Jing-Wen Zhang Feng Jin Bo Chen Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes? A systematic review and meta-analysis Chronic Diseases and Translational Medicine |
| title | Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes? A systematic review and meta-analysis |
| title_full | Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes? A systematic review and meta-analysis |
| title_fullStr | Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes? A systematic review and meta-analysis |
| title_full_unstemmed | Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes? A systematic review and meta-analysis |
| title_short | Can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes? A systematic review and meta-analysis |
| title_sort | can axillary radiotherapy replace axillary dissection for patients with positive sentinel nodes a systematic review and meta analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2095882X1630069X |
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