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乳腺癌手术治疗后的生存率。

Survival after surgical treatment of breast cancer.

作者信息

Taucher Susanne, Jakesz Raimund

机构信息

Department of Surgery, Vienna University Medical School, Waehringer Guertel 18-20, 1090 Vienna, Austria.

出版信息

Langenbecks Arch Surg. 2004 Apr;389(2):75-82. doi: 10.1007/s00423-004-0465-z. Epub 2004 Feb 18.

Abstract

BACKGROUND

The principle objective of locoregional treatment in breast cancer is to eradicate local disease in the breast and local lymph nodes. Surgery in breast cancer provides locoregional control of the disease by resection appropriate to oncological principles, i.e. complete resection with tumour-free margins. Type and extent of breast surgery is dependent on tumour stage; beyond that and even more importantly, prognosis of an individual patient depends upon its stage at diagnosis.

METHOD

We reviewed the current literature, working out stage-specific survival and disease-free survival (DFS). The reported data were considered, according to stage and type of surgery, and a clear survey up to 20 years after surgery was depicted. Additionally, we assessed quality of life after breast cancer surgery.

RESULTS

Overall survival (OS) rates after 5 years range from 93-84% in women diagnosed with stage I disease to 18% in women diagnosed with stage IV disease. In the management of stages I and II breast cancer, breast conservation with lumpectomy and radiation is a preferable alternative to mastectomy, with equivalent patient outcome. In stages III and IV breast cancer, surgery allows local control of the disease, but prognosis depends predominantly on the response to systemic treatment, as does prognosis in all breast cancer patients.

CONCLUSION

The reported data distributing patients outcome according to stage and surgical treatment provide a clear summary in order to estimate an individual patient's risk.

摘要

背景

乳腺癌局部区域治疗的主要目标是根除乳腺及局部淋巴结的疾病。乳腺癌手术通过依据肿瘤学原则进行切除,即完整切除且切缘无肿瘤,从而实现对疾病的局部区域控制。乳腺手术的类型和范围取决于肿瘤分期;除此之外,更重要的是,个体患者的预后取决于其诊断时的分期。

方法

我们回顾了当前的文献,计算特定分期的生存率和无病生存率(DFS)。根据手术分期和类型对报告的数据进行分析,并描绘了术后长达20年的清晰概况。此外,我们评估了乳腺癌手术后的生活质量。

结果

诊断为I期疾病的女性5年后的总生存率(OS)为93% - 84%,而诊断为IV期疾病的女性为18%。在I期和II期乳腺癌的治疗中,保乳手术加肿块切除术及放疗是乳房切除术的一种更优选择,患者预后相当。在III期和IV期乳腺癌中,手术可实现对疾病的局部控制,但预后主要取决于对全身治疗的反应,所有乳腺癌患者均如此。

结论

所报告的根据分期和手术治疗对患者预后进行分类的数据提供了一个清晰的总结,以便评估个体患者的风险。

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