What is the z11 trial?

The American College of Surgeons Oncology Group (ACOSOG) Z0011 trial was a multicenter noninferiority study which enrolled and randomized 891 patients with breast cancer, T1-2 disease, clinically negative axillary nodes, 1 or 2 macrometastatic nodes on SLNB, and a plan for breast conserving therapy consisting of …

What is sentina trial?

The SENTINA (SENTinel NeoAdjuvant) study was designed to evaluate a specific algorithm for timing of a standardised sentinel-lymph-node biopsy procedure in patients who undergo neoadjuvant chemotherapy.

What is Slnd?

Sentinel lymph node dissection (SLND) is a minimally invasive technique to stage axillary lymph nodes in breast cancer.

When is axillary node dissection indicated?

Current indications for a level I or II axillary dissection in patient undergoing a mastectomy include the following: Preoperative diagnosis of positive axillary lymph node metastasis on fine-needle aspiration or core biopsy. Prior inadequate axillary lymph node dissection.

What is regional nodal irradiation?

Radiotherapy to the chest wall and regional lymph nodes, termed regional nodal irradiation, which is commonly used after mastectomy in women with node-positive breast cancer who are treated with adjuvant systemic therapy, reduces locoregional and distant recurrence and improves overall survival.

What is removed in a modified radical mastectomy?

Surgery for breast cancer in which the breast, most or all of the lymph nodes under the arm, and the lining over the chest muscles are removed. Sometimes the surgeon also removes part of the chest wall muscles.

What are the side effects of having lymph nodes removed?

Side effects of lymph node removal

• Wound pain. Most people will have some pain after the operation, which usually improves as the wound heals.
• Neck/shoulder/hip stiffness and pain. These are the most common problems if lymph nodes in your neck, armpit or groin were removed.
• Seroma/lymphocele.
• Lymphoedema.

What is the difference between sentinel and axillary lymph nodes?

Axillary dissection removes more nodes and disrupts more of the normal tissue in the underarm area than a sentinel node biopsy. So, it’s more likely to affect arm function and more likely to cause lymphedema. For this reason, sentinel node biopsy is the preferred method to check the axillary lymph nodes.

What does clinically node negative mean?

Clinically node negative is defined as no signs of axillary lymph node metastases, consisting of a negative physical examination of the axilla and preoperative axillary ultrasound (or negative cyto−/histopathology in case of a suspicious axillary lymph node) [30].

Does whole breast radiation include lymph nodes?

This type of radiation is delivered by an x-ray machine that delivers a precise area of radiation either to the whole breast, or the chest wall (if done after mastectomy). Sometimes, radiation will also target the lymph nodes in the armpit or neck area or under the breast bone.

When did the ACOSOG z0011 clinical trial end?

Design, setting, and participants: The ACOSOG Z0011 phase 3 randomized clinical trial enrolled patients from May 1999 to December 2004 at 115 sites (both academic and community medical centers). The last date of follow-up was September 29, 2015, in the ACOSOG Z0011 (Alliance) trial.

Which is an additional step in a meta-analysis?

Additional statistical examinations involve sensitivity analyses, metaregressions, subgroup analyses, and calculation of heterogeneity metrics, such as Q or I 2 [ 20 ]. It is fundamental to assess and, if present, explain the possible sources of heterogeneity.

What should be included and excluded in a study?

You should establish in advance the inclusion (such as type of study, language of publication, among others) and exclusion (such as minimal sample size, among others) criteria. Keep in mind that the current consensus advises against strict criteria concerning language or sample size.

What are the eligibility criteria for a study?

Study must have been conducted in an elementary school setting (equivalent to U.S. kindergarten through 6th grade) Exclude studies addressing combined school settings of combined elementary and middle school years with no subgroup analysis matching required group