Badgwell Brian D, Povoski Stephen P, Abdessalam Shahab F, Young Donn C, Farrar William B, Walker Michael J, Yee Lisa D, Zervos Emmanuel E, Carson William E, Burak William E
Division of Surgical Oncology, Department of Surgery, Arthur G. James Cancer Hospital, and Richard J. Solove Research Institute, The Ohio State University, Columbus, Ohio 43210, USA.
Ann Surg Oncol. 2003 May;10(4):376-80. doi: 10.1245/aso.2003.07.026.
Sentinel lymph node biopsy (SLNB) is gaining acceptance as an alternative to axillary lymph node dissection. The purpose of this study was to determine the frequency and pattern of disease recurrence after SLNB.
Two-hundred twenty-two consecutive patients undergoing SLNB from April 6, 1998, to October 27, 1999, and who were >or=24 months out from their procedure were identified from a prospectively maintained database. Retrospective chart review and data analysis were performed to identify variables predictive of recurrence.
The median patient follow-up was 32 months (range, 24-43 months). A total of 159 patients (72%) were sentinel lymph node (SLN) negative and had no further axillary treatment. Five of these patients (3.1%) developed a recurrence (one local and four distant), with no isolated regional (axillary) recurrences. Sixty-three patients (28%) were SLN positive and underwent a subsequent axillary lymph node dissection. Six of these patients (9.5%) developed a recurrence (three local, one regional, and two distant). Pathologic tumor size (P <.001), lymphovascular invasion (P =.018), and a positive SLN (P =.048) were all statistically significantly associated with disease recurrence.
With a minimum follow-up of 24 months, patients with a negative SLN and no subsequent axillary treatment demonstrate a low frequency of disease recurrence. This supports the use of SLNB as the sole axillary staging procedure in SLN-negative patients.
前哨淋巴结活检（SLNB）作为腋窝淋巴结清扫术的替代方法正逐渐被接受。本研究的目的是确定SLNB后疾病复发的频率和模式。
从一个前瞻性维护的数据库中识别出1998年4月6日至1999年10月27日连续接受SLNB且术后至少24个月的222例患者。进行回顾性病历审查和数据分析以确定预测复发的变量。
患者的中位随访时间为32个月（范围24 - 43个月）。共有159例患者（72%）前哨淋巴结（SLN）阴性且未接受进一步的腋窝治疗。其中5例患者（3.1%）出现复发（1例局部复发和4例远处复发），无孤立的区域（腋窝）复发。63例患者（28%）SLN阳性并随后接受了腋窝淋巴结清扫术。其中6例患者（9.5%）出现复发（3例局部复发、1例区域复发和2例远处复发）。病理肿瘤大小（P <.001）、淋巴管浸润（P =.018）和SLN阳性（P =.048）均与疾病复发有统计学显著相关性。
在至少24个月的随访中，SLN阴性且未接受后续腋窝治疗的患者疾病复发频率较低。这支持将SLNB用作SLN阴性患者唯一的腋窝分期程序。
