Axillary Lymph Node Dissection Versus no Dissection in Breast Cancer With Positive Sentinel Lymph Node (Z0011-China)
A Prospective Randomized Multicenter Phase III Study of Axillary Lymph Node Dissection Versus no Dissection in Breast Cancer With Positive Sentinel Lymph Node--the Validation of Z0011 in China
The recently randomized trial (ASCOG Z0011) support that among patients with limited sentinel lymph node (SLN) metastatic breast cancer treated with breast conservation and systemic therapy, the use of sentinel lymph node biopsy (SLNB) alone compared with axillary lymph node dissection (ALND) did not result in inferior survival. These patients, therefore, are unlikely to benefit from further surgery that results in a longer period of hospitalization, higher costs and higher postoperative morbidity. This result has been written in the 2012 National Comprehensive Cancer Network Clinical Practice Guidelines.
However, Limitations of Z0011, such as failure to achieve target accrual and possible randomization imbalance favoring the SLNB-alone group, must be considered. In the other hand, further testing in different country are needed.
The investigators design and begin a prospective randomized multicenter phase III study of ALND vs. no ALND in breast Cancer with positive SLN--the validation of Z0011 in China.
調査の概要
状態
条件
詳細な説明
OBJECTIVES:
To determine the effects of complete axillary lymph node dissection (ALND) on survival of patients with sentinel lymph node (SLN) metastasis of breast cancer.
OUTLINE: This is a randomized multicenter study. Before randomization, all women were stratified according to age (≤50 years, >50 years), tumor size(≤2cm, >2cm) and research center. All the patients underwent lumpectomy and sentinel lymph node biopsy (SLNB). Eligible women were randomly assigned to ALND or no ALND Active Comparator: Patients undergo axillary lymph node dissection involving removal of at least level I and II nodes.
Experimental: No surgery of axillary lymph node in this arm. All the patients were to receive whole-breast opposing tangential-field radiation therapy. The use of adjuvant systemic therapy was determined by the treating physician according to the recently NCCN.
Patients are followed up every 4 months for the first 2 years, every 6 months from the third year to the fifth year, and then annually for a total of 10 years.
研究の種類
段階
- フェーズ 3
連絡先と場所
研究場所
-
-
Shandong
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Jinan、Shandong、中国、250117
- Shandong Cancer Hospital And Institute
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Female;
- Patient aged 18 years and above;
- Patient with histological proven invasive breast cancer;
- Clinical T1-T2 disease with no distant metastasis;
- Patient with clinical N0 status;
- Patient for whom conservative surgery with sentinel lymph node (SLN) technique is feasible from the start in terms of carcinologic;
- Patient with positive SLNs 1~2;
- Signed consent to participate.
Exclusion Criteria:
- History of neoadjuvant chemotherapy or hormone therapy;
- History of breast cancer (ipsilateral, i.e. recurrence, or contralateral breast);
- History of any other invasive cancer;
- Initial metastatic disease known;
- Pregnant women or lactating women;
- Impossibility to undergo medical examinations of the study for geographical, social or psychological reasons.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
アクティブコンパレータ：Axillary Lymph Node Dissection
After sentinel lymph node biopsy, surgery for standard axillary lymph node dissection.
Pathological evaluation (include intraoperative pathological examination) is performed routinely.
All women were to receive whole-breast opposing tangential-field radiation therapy.
Adjuvant systemic therapy was determined by the treating physician.
|
Sentinel lymph nodes are identified with the combining use of intraoperative gamma detector and/or blue dye.
他の名前：
touch imprint cytology and/or frozen section and/or OSNA
Axillary lymph node dissection involving removal of at least level I and II nodes.
他の名前：
H&E and IHC
Adjuvant systemic therapy was determined by the treating physician according to the recently NCCN.
他の名前：
Whole-breast opposing tangential-field radiation therapy.
|
|
実験的：Non-Axillary Lymph Node Dissection
After sentinel lymph node biopsy, no surgery of axillary lymph node In this study, the absence of surgery is the experimental arm (non-inferiority trial).
Pathological evaluation (include intraoperative pathological examination) is performed routinely.
All women were to receive whole-breast opposing tangential-field radiation therapy.
Adjuvant systemic therapy was determined by the treating physician.
|
Sentinel lymph nodes are identified with the combining use of intraoperative gamma detector and/or blue dye.
他の名前：
touch imprint cytology and/or frozen section and/or OSNA
H&E and IHC
Adjuvant systemic therapy was determined by the treating physician according to the recently NCCN.
他の名前：
Whole-breast opposing tangential-field radiation therapy.
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Disease Free Survival
時間枠：Time to relapse or progression up to 10 years
|
Time from randomization to relapse or death.
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Time to relapse or progression up to 10 years
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Overall Survival
時間枠：Time to death up to 10 years
|
Time from randomization to date of death.
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Time to death up to 10 years
|
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Axillary Recurrence Rate
時間枠：Time to local relapse up to 10 years
|
Estimate the incidence of axillary recurrence after surgery followed by axillary dissection or after surgery alone.
|
Time to local relapse up to 10 years
|
協力者と研究者
捜査官
- 主任研究者：Jiong Wu, MD、Fudan University
- 主任研究者：Tao Ouyang, MD、Beijing Cancer Hospital and Institute
- 主任研究者：Feng-xi Su, MD、Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
- 主任研究者：Hong-yuan Li, MD、First Affiliated Hospital of Chongqing Medical University
研究記録日
主要日程の研究
研究開始
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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