ArticleJournal of the American College of Surgeons2013
Impact of the american college of surgeons oncology group Z0011 criteria applied to a contemporary patient population.
Article in Journal of the American College of Surgeons, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 5 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Can axillary lymph node dissection be omitted in breast cancer patients with 1-2 positive sentinel nodes? A systematic review and meta-analysis.The oncologist · 2025Pooled it
- Axillary management in patients with clinical node-negative early breast cancer and positive sentinel lymph node: a systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Axilla lymph node dissection can be safely omitted in patients with 1-2 positive sentinel nodes receiving mastectomy: a large multi-institutional study and a systemic meta-analysis.Breast cancer research and treatment · 2022Pooled it
- Comparing Early-Stage Breast Cancer Patients with Sentinel Lymph Node Metastasis with and without Completion Axillary Lymph Node Dissection: A Systematic Review and Meta-Analysis.Asian Pacific journal of cancer prevention : APJCP · 2022Pooled it
- Axillary Management in Women with Early Breast Cancer and Limited Sentinel Node Metastasis: A Systematic Review and Metaanalysis of Real-World Evidence in the Post-ACOSOG Z0011 Era.Annals of surgical oncology · 2021Pooled it
- The feasibility of the ACOSOG Z0011 Criteria to Chinese Breast Cancer Patients: A Multicenter Study.Scientific reports · 2015Trial
- Oncologic safety of breast-conserving surgery in node-positive breast cancer: a systematic review and meta-analysis.Gland surgery · 2026Article
- Article
- Article
- An exploratory study of whether axillary lymph node dissection can be avoided in breast cancer patients with positive lymph nodes.Translational cancer research · 2024Article
- Article
- Can We Avoid Axillary Lymph Node Dissection (ALND) in Patients with 1-2 Positive Sentinel/Low Axillary Lymph Nodes (SLN/LAS+) in the Indian Setting?Indian journal of surgical oncology · 2021Article
- Application of the ACOSOG Z0011 criteria to Chinese patients with breast cancer: a prospective study.World journal of surgical oncology · 2021Article
- Effect of non-sentinel metastasis on adjuvant treatment decisions and survival in Z0011 eligible non-screened detected breast cancer population.Ecancermedicalscience · 2021Article
- The Adventure of Axillary Treatment in Early Stage Breast Cancer.European journal of breast health · 2020Review
- Shortcomings of ultrasound-guided fine needle aspiration in the axillary management of women with breast cancer.World journal of surgical oncology · 2019Article
- Non-sentinel axillary tumor burden applying the ACOSOG Z0011 eligibility criteria to a large routine cohort.Breast cancer research and treatment · 2019Article
- A prospective feasibility study applying the ACOSOG Z0011 criteria to Japanese patients with early breast cancer undergoing breast-conserving surgery.International journal of clinical oncology · 2018Article
- Different outcome in node-positive breast cancer patients found by axillary ultrasound or sentinel node procedure.Breast cancer research and treatment · 2017Article
- Axillary Dissection and Nodal Irradiation Can Be Avoided for Most Node-positive Z0011-eligible Breast Cancers: A Prospective Validation Study of 793 Patients.Annals of surgery · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe American College of Surgeons Oncology Group (ACOSOG) Z0011 trial concluded that axillary lymph node dissection (ALND) may not be necessary for all patients with sentinel lymph node (SLN) metastasis undergoing breast-conserving therapy (BCT). The aim of this study was to assess applicability of Z0011 results to our patient population and determine what percentage may be affected by these results. STUDY
designPatients with clinical T1-2, N0 breast cancer, treated with surgery first between 1994 and 2009, who had 1 to 2 positive SLNs, were included in this study. Kaplan-Meier survival curves were calculated and log-rank used to compare overall survival (OS) and disease-free survival (DFS) for ALND vs SLN dissection (SLND) alone in 2 patient populations: patients undergoing BCT or total mastectomy (TM) and patients undergoing BCT only.
resultsOf 861 patients, 188 (21.8%) underwent SLND alone. Of 488 (56.7%) patients who underwent BCT, 125 (25.6%) had SLND alone. Of 412 patients undergoing TM, 67 (16.3%) had SLND alone. Patients undergoing ALND were significantly younger, had larger tumors, macrometastasis, and extranodal extension in both populations. Compared with the Z0011 cohort, our BCT patients had more T1 tumors (76.0% vs 69.3%, p = 0.01) and more grade II to III tumors (87.3% vs 76.2%, p < 0.0001). After adjusting for T-stage, there were no significant differences in DFS and OS between patients undergoing SLND alone or ALND in both populations.
conclusionsExamination of our breast cancer patients with Z0011 trial criteria suggests that almost 75% of SLN-positive patients would be candidates to avoid ALND if they undergo BCT.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.