The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patients
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://revista.spcir.com/index.php/spcir/article/view/14 |
Resumo: | Introduction and aims: The Sentinel Node (SN) concept emerged as a way to improve Breast Cancer (BC) staging and to reduce the morbidity of the Axillary Dissection (AD). But the influence of the SN concept on long term BC outcomes is not well defined. The aim of this work is to assess the impact of the SN concept on the overall and disease-free survival and on the axillary recurrence, in a prospectively controlled series of BC patients. Methods: This revision includes 394 consecutive BC patients, from two successive randomized clinical protocols. The first (n=166) elapsed from April 2001 to June 2003 and the second (n=228) accrued from Septem- ber 2003 to January 2005. The first study included patients with tumours less than 30mm and the pN0sn patients were randomized between AD and SN only. The second study was divided into two groups. Group A received uT1 patients; pN0sn patients were spared from the AD and pN+sn patients were submitted to AD. Group B received uT2 patients; those with pN0sn were randomized between AD and SN only. Patients were followed-up at the out-patient breast clinic, every 3 months during the first 3 years, every 6 months until 5 five years and then yearly. Events were prospectively registered in an Institutional database. Results: Median patient’s age was 55 years (range: 20-78). Median follow-up time was 66 months (range: 4-100). Two men were included. Mean overall survival time for SN only patients was 98 months and for the AD patients was 93 months (p=0.003). Mean relapse-free survival time for the SN only patients was 97 months and for the AD patients was 99 months (p-0.43). At five years of follow-up, overall survival was 98% for the SN only group and 92% for the AD group and disease-free survival was 99% for the SN only group and 100% for the AD group. There were not detected axillary nodal recurrences among SN only patients or between AD patients. Conclusions: Long-term follow-up of BC patients submitted to SN biopsy-only showed similar results to AD submitted patients, in terms of overall survival, disease-free survival and axillary node recurrence, therefore ensuring clinical long-lasting adequacy of the SN concept. Keywords: Breast Cancer, Sentinel Node, Long-term follow-up. |
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The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patientsO impacto do conceito de Gânglio Sentinela na sobrevivência livre de doença e global e na recorrência axilar de doentes com Cancro da MamaIntroduction and aims: The Sentinel Node (SN) concept emerged as a way to improve Breast Cancer (BC) staging and to reduce the morbidity of the Axillary Dissection (AD). But the influence of the SN concept on long term BC outcomes is not well defined. The aim of this work is to assess the impact of the SN concept on the overall and disease-free survival and on the axillary recurrence, in a prospectively controlled series of BC patients. Methods: This revision includes 394 consecutive BC patients, from two successive randomized clinical protocols. The first (n=166) elapsed from April 2001 to June 2003 and the second (n=228) accrued from Septem- ber 2003 to January 2005. The first study included patients with tumours less than 30mm and the pN0sn patients were randomized between AD and SN only. The second study was divided into two groups. Group A received uT1 patients; pN0sn patients were spared from the AD and pN+sn patients were submitted to AD. Group B received uT2 patients; those with pN0sn were randomized between AD and SN only. Patients were followed-up at the out-patient breast clinic, every 3 months during the first 3 years, every 6 months until 5 five years and then yearly. Events were prospectively registered in an Institutional database. Results: Median patient’s age was 55 years (range: 20-78). Median follow-up time was 66 months (range: 4-100). Two men were included. Mean overall survival time for SN only patients was 98 months and for the AD patients was 93 months (p=0.003). Mean relapse-free survival time for the SN only patients was 97 months and for the AD patients was 99 months (p-0.43). At five years of follow-up, overall survival was 98% for the SN only group and 92% for the AD group and disease-free survival was 99% for the SN only group and 100% for the AD group. There were not detected axillary nodal recurrences among SN only patients or between AD patients. Conclusions: Long-term follow-up of BC patients submitted to SN biopsy-only showed similar results to AD submitted patients, in terms of overall survival, disease-free survival and axillary node recurrence, therefore ensuring clinical long-lasting adequacy of the SN concept. Keywords: Breast Cancer, Sentinel Node, Long-term follow-up. Introdução e objectivos: O Conceito de Gânglio Sentinela (GS) emergiu como uma forma de melhorar o estadiamento de doentes com Cancro da Mama (CM) e de reduzir a morbilidade do Esvaziamento Axilar (EA). Mas a influência do Conceito de GS nos re- sultados do tratamento do CM, a longo prazo, não está bem definida. O objectivo deste trabalho é avaliar o impacto do conceito de GS na sobrevivência global e livre de doença, assim como na recorrência axilar, numa série controlada e prospectiva de doentes com CM. Métodos: Esta revisão inclui 394 doentes consecutivos com CM, que participaram em dois ensaios randomizados sucessivos. O primeiro (n=166) decorreu de abril de 2001 a junho de 2003 e o segundo (n=228) de setembro de 2003 a janeiro de 2005. O primeiro estudo incluiu doentes com tumores de tamanho igual ou inferior a 30mm, pN0sn, que foram randomizados entre GS e EA. O segundo estudo foi dividido em dois grupos. O grupo A recebeu doentes uT1; os doentes pN0sn foram poupados ao EA e os doentes pN+sn foram submetidos a EA. O Grupo B recebeu os doentes uT2; os doentes pN0sn foram randomizados entre GS e EA. Os doentes foram acompanhados na consulta externa, a cada 3 meses nos primeiros 3 anos, depois a cada 6 meses até perfazer 5 anos e, depois, anualmente. Os eventos foram registados prospectivamente numa base de dados institucional. Resultados: A idade mediana foi de 55 anos (variação: 20-78). O tempo mediano de acompanhamento foi de 66 meses (variação: 4-100). Foram incluídos dois homens. A sobrevivência global (SG) média para o grupo GS foi de 98 meses e para o grupo EA foi de 93 meses (p=0.003). A sobrevivência livre de recorrência (SLD) para o grupo GS foi de 97 meses e para o grupo EA foi de 99 meses (p=0.43). Aos cinco anos, a SG para o grupo GS foi de 98% e para o grupo EA foi de 92%; a SLD para o grupo GS foi de 99% e para o grupo EA foi de 100%. Não foram detectadas recorrências ganglionares axilares em ambos os grupos. Conclusões: O seguimento de longa duração de doentes com CM submetidos apenas a biópsia de GS mostrou resultados semelhantes aos dos doentes submetidos a EA, relativamente à SG, SLD e recorrência axilar. Deste modo, fica assegurado que o conceito de GS é adequado e duradouro. Palavras-Chave: Cancro da Mama, Gânglio Sentinela, Seguimento de Longa Duração.Sociedade Portuguesa de Cirurgia2013-03-18info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://revista.spcir.com/index.php/spcir/article/view/14Revista Portuguesa de Cirurgia; No 24 (2013): Março 2013 - II Série; 9-17Revista Portuguesa de Cirurgia; No 24 (2013): Março 2013 - II Série; 9-172183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spcir.com/index.php/spcir/article/view/14https://revista.spcir.com/index.php/spcir/article/view/14/14Copyright (c) 2016 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessFougo, José LuisDinis-Ribeiro, MárioDias, TeresaCastro, FernandoReis, PauloGiesteira, LaurindaAraújo, Cláudia2024-03-14T22:04:56Zoai:revista.spcir.com:article/14Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T04:00:46.580940Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patients O impacto do conceito de Gânglio Sentinela na sobrevivência livre de doença e global e na recorrência axilar de doentes com Cancro da Mama |
title |
The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patients |
spellingShingle |
The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patients Fougo, José Luis |
title_short |
The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patients |
title_full |
The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patients |
title_fullStr |
The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patients |
title_full_unstemmed |
The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patients |
title_sort |
The impact of the Sentinel Node concept on the overall survival, disease-free survival and axillary recurrence of Breast Cancer patients |
author |
Fougo, José Luis |
author_facet |
Fougo, José Luis Dinis-Ribeiro, Mário Dias, Teresa Castro, Fernando Reis, Paulo Giesteira, Laurinda Araújo, Cláudia |
author_role |
author |
author2 |
Dinis-Ribeiro, Mário Dias, Teresa Castro, Fernando Reis, Paulo Giesteira, Laurinda Araújo, Cláudia |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Fougo, José Luis Dinis-Ribeiro, Mário Dias, Teresa Castro, Fernando Reis, Paulo Giesteira, Laurinda Araújo, Cláudia |
description |
Introduction and aims: The Sentinel Node (SN) concept emerged as a way to improve Breast Cancer (BC) staging and to reduce the morbidity of the Axillary Dissection (AD). But the influence of the SN concept on long term BC outcomes is not well defined. The aim of this work is to assess the impact of the SN concept on the overall and disease-free survival and on the axillary recurrence, in a prospectively controlled series of BC patients. Methods: This revision includes 394 consecutive BC patients, from two successive randomized clinical protocols. The first (n=166) elapsed from April 2001 to June 2003 and the second (n=228) accrued from Septem- ber 2003 to January 2005. The first study included patients with tumours less than 30mm and the pN0sn patients were randomized between AD and SN only. The second study was divided into two groups. Group A received uT1 patients; pN0sn patients were spared from the AD and pN+sn patients were submitted to AD. Group B received uT2 patients; those with pN0sn were randomized between AD and SN only. Patients were followed-up at the out-patient breast clinic, every 3 months during the first 3 years, every 6 months until 5 five years and then yearly. Events were prospectively registered in an Institutional database. Results: Median patient’s age was 55 years (range: 20-78). Median follow-up time was 66 months (range: 4-100). Two men were included. Mean overall survival time for SN only patients was 98 months and for the AD patients was 93 months (p=0.003). Mean relapse-free survival time for the SN only patients was 97 months and for the AD patients was 99 months (p-0.43). At five years of follow-up, overall survival was 98% for the SN only group and 92% for the AD group and disease-free survival was 99% for the SN only group and 100% for the AD group. There were not detected axillary nodal recurrences among SN only patients or between AD patients. Conclusions: Long-term follow-up of BC patients submitted to SN biopsy-only showed similar results to AD submitted patients, in terms of overall survival, disease-free survival and axillary node recurrence, therefore ensuring clinical long-lasting adequacy of the SN concept. Keywords: Breast Cancer, Sentinel Node, Long-term follow-up. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-03-18 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
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https://revista.spcir.com/index.php/spcir/article/view/14 |
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https://revista.spcir.com/index.php/spcir/article/view/14 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spcir.com/index.php/spcir/article/view/14 https://revista.spcir.com/index.php/spcir/article/view/14/14 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2016 Revista Portuguesa de Cirurgia info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2016 Revista Portuguesa de Cirurgia |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
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Sociedade Portuguesa de Cirurgia |
dc.source.none.fl_str_mv |
Revista Portuguesa de Cirurgia; No 24 (2013): Março 2013 - II Série; 9-17 Revista Portuguesa de Cirurgia; No 24 (2013): Março 2013 - II Série; 9-17 2183-1165 1646-6918 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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