Axillary lymph node dissection versus sentinel lymph node biopsy alone for early breast cancer with sentinel node metastasis: A meta-analysis

被引:50
作者
Li, C. Z. [1 ]
Zhang, P. [2 ]
Li, R. W. [1 ]
Wu, C. T. [1 ]
Zhang, X. P. [1 ]
Zhu, H. C. [1 ]
机构
[1] Hebei United Univ, Oncol Surg, Affiliate Hosp, Tangshan 063000, Hebei, Peoples R China
[2] Hebei United Univ, Nursing & Rehabil Coll, Tangshan 063000, Hebei, Peoples R China
来源
EJSO | 2015年 / 41卷 / 08期
关键词
Axillary lymph node; Breast cancer; Dissection; Sentinel lymph node; FOLLOW-UP; AMERICAN-COLLEGE; CLINICAL-TRIAL; SURVIVAL; MULTICENTER; RECURRENCE; MORBIDITY; OUTCOMES; IMPACT; LYMPHADENECTOMY;
D O I
10.1016/j.ejso.2015.05.007
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: In early breast cancer patients with sentinel node metastasis, the effect of axillary lymph node dissection (ALND) is controversial. The purpose of this study is to compare the safety and efficacy of sentinel lymph node biopsy (SLNB) alone versus ALND in patients with early breast cancer and sentinel node metastasis. Methods: We searched PubMed, Embase, Web of Science, and Cochrane Library databases from 1965 to February 2014. All data were analyzed using Review Manager Software 5.2. Results: 12 studies, which included 130,575 patients from five randomized controlled trials and seven observational studies, met our inclusion criteria. 26,870 early breast cancer patients underwent SLNB alone and 103,705 underwent ALND. Patients underwent ALND had more paresthesia (risk ratio [RR] 0.26, 95% confidence interval [CI] 0.20-0.33; p < 0.01) and lymphedema (RR 0.28, 95% CI 0.20-0.41; p < 0.01) than those had SLNB alone. There were no significant differences in overall survival (hazard ratio [HR] 0.95, 95% CI 0.85-1.06; p = 0.35), disease-free survival (HR 1.00, 95% CI 0.98-1.02, p = 0.96), and locoregional recurrence (RR 0.92, 95% Cl 0.59-1.44; p = 0.73). Conclusion: Current evidence indicates that axillary dissection may be omitted in early breast cancer patients with sentinel lymph metastasis. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:958 / 966
页数:9
相关论文
共 51 条
[21]   Tips for learners of evidence-based medicine: 4. Assessing heterogeneity of primary studies in systematic reviews and whether to combine their results [J].
Hatala, R ;
Keitz, S ;
Wyer, P ;
Guyatt, G .
CANADIAN MEDICAL ASSOCIATION JOURNAL, 2005, 172 (05) :661-665
[22]  
Higgins JPT, 2010, SURGERY, DOI DOI 10.1016/J.SURG.2009.06.030
[23]   Low locoregional failure rates in selected breast cancer patients with tumor-positive sentinel lymph nodes who do not undergo completion axillary dissection [J].
Hwang, Rosa F. ;
Gonzalez-Angulo, Ana M. ;
Yi, Min ;
Buchholz, Thomas A. ;
Meric-Bernstam, Funda ;
Kuerer, Henry M. ;
Babiera, Gildy V. ;
Tereffe, Welela ;
Liu, Diane D. ;
Hunt, Kelly K. .
CANCER, 2007, 110 (04) :723-730
[24]   Sentinel lymph node dissection provides axillary control equal to complete axillary node dissection in breast cancer patients with lobular histology and a negative sentinel node [J].
Khakpour, N ;
Hunt, KK ;
Kuerer, HM ;
Yi, M ;
Meric-Bernstam, F ;
Ross, MI ;
Lucci, A .
AMERICAN JOURNAL OF SURGERY, 2005, 190 (04) :598-601
[25]   Axillary Recurrence Rate Following Negative Sentinel Node Biopsy for Invasive Breast Cancer: Long-Term Follow-Up (vol 17, pg 552, 2010) [J].
Kiluk, John V. ;
Ly, Quan P. ;
Santillan, Alfredo A. ;
Meade, Tammi ;
Ramos, Daniel ;
Reintgen, Douglas S. ;
Dessureault, Sophie ;
Davis, Michelle ;
Shamehdi, Corinne ;
Cox, Charles E. .
ANNALS OF SURGICAL ONCOLOGY, 2010, 17 (02) :552-557
[26]   Impact of Omission of Axillary Lymph Node Dissection After Negative Sentinel Lymph Node Biopsy: 70-Month Follow-up [J].
Kim, Hee Jeong ;
Son, Byung Ho ;
Lim, Woo Sung ;
Seo, Jin Yong ;
Koh, Beom Seok ;
Lee, Jong Won ;
Gong, Gyung Yup ;
Ahn, Sei Hyun .
ANNALS OF SURGICAL ONCOLOGY, 2010, 17 (08) :2126-2131
[27]   A Comparison of Outcomes for the Patients with Pathologically Node-negative Breast Cancer and Who Were Treated Either with Sentinel Lymph Node Biopsy Only or with Conventional Axillary Lymph Node Dissection [J].
Kim, Hyun-Ah ;
Jo, Eun-Jeong ;
Kim, Min-Suk ;
Kim, Yang-Hee ;
Paik, Nam-Sun ;
Moon, Nan-Mo ;
Lee, Jong-Inn ;
Yang, Kwang Mo ;
Noh, Woo-Chul .
JOURNAL OF BREAST CANCER, 2009, 12 (04) :265-271
[28]   A nonrandomized follow-up comparison between standard axillary node dissection and sentinel node biopsy in breast cancer [J].
Konstantinjuk, Peter ;
Schrenk, Peter ;
Reitsamer, Roland ;
Koeberle-Wuehrer, Roswitha ;
Tausch, Christoph ;
Roka, Sebastian ;
Riedle, Otto ;
Poestiberger, Sabine ;
Hecke, Dieter ;
Janauer, Michael ;
Haid, Anton .
BREAST, 2007, 16 (05) :520-526
[29]   Technical outcomes of sentinel-lymph-node resection and conventional axillary-lymph-node dissection in patients with clinically node-negative breast cancer: results from the NSABP B-32 randomised phase III trial [J].
Krag, David N. ;
Anderson, Stewart J. ;
Bjulian, Thomas ;
Brown, Ann M. ;
Harlow, Seth P. ;
Ashikaga, Takamaru ;
Weaver, Donald L. ;
Miller, Barbara J. ;
Jalovec, Lynne M. ;
Frazier, Thomas G. ;
Noyes, R. Dirk ;
Robidoux, Andre ;
Scarth, Hugh M. C. ;
Mammolito, Denise M. ;
McCready, David R. ;
Mamounas, Eleftherios P. ;
Costantino, Joseph P. ;
Wolmark, Norman .
LANCET ONCOLOGY, 2007, 8 (10) :881-888
[30]   Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial [J].
Krag, David N. ;
Anderson, Stewart J. ;
Julian, Thomas B. ;
Brown, Ann M. ;
Harlow, Seth P. ;
Costantino, Joseph P. ;
Ashikaga, Takamaru ;
Weaver, Donald L. ;
Mamounas, Eleftherios P. ;
Jalovec, Lynne M. ;
Frazier, Thomas G. ;
Noyes, R. Dirk ;
Robidoux, Andre ;
Scarth, Hugh M. C. ;
Wolmark, Norman .
LANCET ONCOLOGY, 2010, 11 (10) :927-933