Eight-year follow up results of the OTOASOR Trial: The Optimal Treatment Of the Axilla − Surgery Or Radiotherapy after positive sentinel lymph node biopsy in early-stage breast cancer. A randomized, single centre, phase III, non-inferiority trial

Sávolt, Ákos; Péley, Gábor; Csaba, P.; Udvarhelyi, Nóra; Kovács, Eszter; Győrffy, Balázs; Mátrai, Zoltán

doi:10.1016/s0959-8049(17)30090-4

Cited by 33 publications

(51 citation statements)

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“…At the same time, axillary radiation had a comparable axillary contonl result to ALND after a median follow up of 6 years. OTOASOR trial showed a similar result, axillary radiation had a lower lymphoedema rate than ALND and comparable axillary recurrence rate . Patients with positive SLNs also can choose axillary radiation to reduce lymphoedema rate.…”

Section: Discussionmentioning

confidence: 80%

A new model to predict risk of nonsentinel lymph node status in Chinese sentinel lymph node-positive patients after neoadjuvant chemotherapy

Yang

Fan

et al. 2018

Breast J

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There is no previous predictive model to assess risk of nonsentinel lymph node metastases (NSLN) in sentinel lymph node (SLN)-positive breast cancer patients after neoadjuvant chemotherapy (NAT). Our goal was to develop a new predictive model for SLN-positive patients after NAT, and validate this new model. A series of 513 patients with metastases in SLN who received NAT were used to evaluate factors affecting NSLN status. Logistic regression analysis was performed to develop a predictive model, which was validated by a subsequent prospective 138 patients. There were 115 (22.4%) patients with metastases in NSLN followed by axillary lymph node dissection (ALND). Multivariate analysis indicated that tumor (T) stage, number of positive SLN,micrometastases, extracapsular extension (ECE), and clinical response of primary tumor after NAT were significant independent predictors for the NSLN metastases. Area under the curve (AUC) of the model was 0.795 (95% CI, 0.734-0.861). When applied to the prospective series, the model accurately predicted the risk of NSLN disease, AUC was 0.772 (95% CI, 0.653-0.845). We present a new predictive model to assess the risk of NSLN status in Chinese SLN-positive breast cancer patients after NAT. The predictive model performed well in prospective validation but needs to be further studied in external center patients before application to clinical use.

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Section: Discussionmentioning

confidence: 80%

A new model to predict risk of nonsentinel lymph node status in Chinese sentinel lymph node-positive patients after neoadjuvant chemotherapy

Yang

Fan

et al. 2018

Breast J

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“…Similarly, the OTOASOR trial randomized pT < 3cm pN1 patients to either completion ALND or axillary radiotherapy. At long‐term follow‐up (median 8 years), there was no difference in overall survival or rates of axillary recurrence in either group.…”

Section: Treating the Axilla When Radical Therapy Is Requiredmentioning

confidence: 99%

Twenty‐five years of change in the management of the axilla in breast cancer

Dixon

Cartlidge

2019

Breast J

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“…In two other "contemporary" studies -a multi-centre, international and randomised phase III study, AMAROS and a single-centre Hungarian, phase III study, OTOASORadjuvant RT was compared with ALND in the patients with metastases in the sentinel lymph nodes [10,11]. Both clinical trials are the studies of the non-inferiority type.…”

Section: Randomized Studies Comparing Radiotherapy Versus Alnd In Wommentioning

confidence: 99%

“…In the evaluation of the quality of life, the differences were observed solely in Table I. The Z0011 [3] and AMAROS studies [10] and OTOASOR [11] the assessment of the symptoms concerning the upper limb. Both better mobility of the limb and less intensive oedemas of the hand and the limb point to the benefit of irradiation.…”

Section: Randomized Studies Comparing Radiotherapy Versus Alnd In Wommentioning

confidence: 99%

Radiotherapy or axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes?

Łacko¹,

Wysocki²

2018

Nowotwory. Journal of Oncology

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Over the years the surgical management of localized breast cancer has become less aggressive. Complete resection of the primary tumour with negative margins replaced mastectomy and is currently a standard of care in a vast majority of women with early breast cancer. Also, an introduction of sentinel lymph node biopsy allowed for giving up axillary lymph node dissection in the patients with pathologically negative sentinel nodes. This development has led to a decrease of morbidity such as lymphedema. However, the standard management of axilla in the patients with positive sentinel lymph nodes remains controversial. Recent studies demonstrated that in the patients with 1 or 2 positive sentinel lymph nodes who undergo breast conserving surgery followed by conventionally fractionated whole-breast radiotherapy, a completion axillary lymph node dissection can be avoided. Furthermore, evidence from three two-phase non-inferiority studies comparing radiotherapy with complete lymph node dissection did not show any significant differences in either overall and disease-free survival, or local control and decrease of the percentage of patients with local adverse effects in radiotherapy arms. However, there are several methodological drawbacks and clinical limitations of these studies, which prevent from general omission of completion axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes. The debate held during V Annual Conference of Nowotwory Journal of Oncology and resulting article discusses the optimal management of axilla in this population.NOWOTWORY

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Eight-year follow up results of the OTOASOR Trial: The Optimal Treatment Of the Axilla − Surgery Or Radiotherapy after positive sentinel lymph node biopsy in early-stage breast cancer. A randomized, single centre, phase III, non-inferiority trial

Cited by 33 publications

References 0 publications

A new model to predict risk of nonsentinel lymph node status in Chinese sentinel lymph node-positive patients after neoadjuvant chemotherapy

A new model to predict risk of nonsentinel lymph node status in Chinese sentinel lymph node-positive patients after neoadjuvant chemotherapy

Twenty‐five years of change in the management of the axilla in breast cancer

Radiotherapy or axillary lymph node dissection in breast cancer patients with positive sentinel lymph nodes?

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