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  • Original Article

    Potential Impact of the Z0011 Trial on the Omission of Axillary Dissection: A Retrospective Cohort Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):297-303

    Summary

    Original Article

    Potential Impact of the Z0011 Trial on the Omission of Axillary Dissection: A Retrospective Cohort Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):297-303

    DOI 10.1055/s-0041-1725052

    Views1

    Abstract

    Objective

    To evaluate the number of patients with early-stage breast cancer who could benefit from the omission of axillary surgery following the application of the Alliance for Clinical Trials in Oncology (ACOSOG) Z0011 trial criteria.

    Methods

    A retrospective cohort study conducted in the Hospital da Mulher da Universidade Estadual de Campinas. The study population included 384 women diagnosed with early-stage invasive breast cancer, clinically negative axilla, treated with breast-conserving surgery and sentinel lymph node biopsy, radiation therapy, chemotherapy and/or endocrine therapy, from January 2005 to December 2010. The ACOSOG Z0011 trial criteria were applied to this population and a statistical analysis was performed to make a comparison between populations.

    Results

    A total of 384 patients underwent breast-conserving surgery and sentinel lymph node biopsy. Of the total number of patients, 86 women underwent axillary lymph node dissection for metastatic sentinel lymph nodes (SNLs). One patient underwent axillary node dissection due to a suspicious SLN intraoperatively, thus, she was excluded fromthe study. Among these patients, 82/86 (95.3%) had one to two involved sentinel lymph nodes andmet the criteria for the ACOSOG Z0011 trial with the omission of axillary lymph node dissection. Among the 82 eligible women, there were only 13 cases (15.9%) of lymphovascular invasion and 62 cases (75.6%) of tumors measuring up to 2 cm in diameter (T1).

    Conclusion

    The ACOSOG Z0011 trial criteria can be applied to a select group of SLNpositive patients, reducing the costs and morbidities of breast cancer surgery.

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    Potential Impact of the Z0011 Trial on the Omission of Axillary Dissection: A Retrospective Cohort Study
  • Original Article

    Factors Associated with Abortion Complications after the Implementation of a Surveillance Network (MUSA Network) in a University Hospital

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(7):507-512

    Summary

    Original Article

    Factors Associated with Abortion Complications after the Implementation of a Surveillance Network (MUSA Network) in a University Hospital

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(7):507-512

    DOI 10.1055/s-0041-1735129

    Views7

    Abstract

    Objective

    To evaluate the factors associated with abortion complications following the implementation of the good-practice surveillance network Mujeres en Situación de Aborto (Women Undergoing Abortion, MUSA, in Spanish).

    Methods

    A cross-sectional study withwomen who underwent abortion due to any cause and in any age group at UNICAMP Women’s Hospital (part of MUSA network), Campinas, Brazil, between July 2017 and Agust 2019. The dependent variable was the presence of any abortion-related complications during hospitalization. The independent variables were clinical and sociodemographic data. The Chi-square test, the Mann-Whitney test, and multiple logistic regression were used for the statistical analysis.

    Results

    Overall, 305 women were enrolled (mean±standard deviation [SD] for age: 29.79±7.54 years). The mean gestational age was 11.17 (±3.63) weeks. Accidental pregnancy occurred in 196 (64.5%) cases, 91 (29.8%) due to contraception failure. At least 1 complication was observed in 23 (7.54%) women, and 8 (34.8%) of them had more than 1. The most frequent complications were excessive bleeding and infection. The factors independently associated with a higher prevalence of complications were higher gestational ages (odds ratio [OR]: 1.22; 95% confidence interval [95%CI]: 1.09 to 1.37) and contraceptive failure (OR: 3.4; 95%CI: 1.32 to 8.71).

    Conclusion

    Higher gestational age and contraceptive failure were associated with a higher prevalence of complications. This information obtained through the surveillance network can be used to improve care, particularly in women more susceptible to unfavorable outcomes.

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