Konstantiniuk Peter, Schrenk Peter, Reitsamer Roland, Koeberle-Wuehrer Roswitha, Tausch Christoph, Roka Sebastian, Riedl Otto, Poestlberger Sabine, Hecke Dieter, Janauer Michael, Haid Anton
University Hospital, Graz, Austria.
Breast. 2007 Oct;16(5):520-6. doi: 10.1016/j.breast.2007.04.001. Epub 2007 Jun 12.
In many countries sentinel node biopsy (SNB) has become the standard of care in breast cancer based on a large number of observational studies but without results from prospective randomized trials. The goal of our study was to evaluate the oncological safety of the SNB in breast cancer in a multicenter, nonrandomized setting with comparable groups.
Between 1996/05 and 2004/11, 2942 patients from 14 departments in Austria with unicentric, unilateral, invasive disease without neoadjuvant therapy were collected in a database. The recommendations of the Austrian Sentinel Node Study Group were to complete a training period (phase I) with 50 cases of SNB followed by axillary lymph node dissection (ALND) to prove a detection rate of > or = 90% and a false-negative rate of < or = 5%. In the executing period (phase II), SNB was followed by ALND only if the sentinel node (SN) contained metastases. We compared the results on disease-free survival, local recurrence rates, distant recurrence rates and overall survival of both groups. Cases from phases I and II generated groups I (n=671) and 2 (n=2271 cases), respectively.
Overall mean follow-up time: 34.41 months.
SNB followed by ALND only in cases with metastases in the SN is a safe procedure and at least equal to ALND in all cases.
在许多国家，基于大量观察性研究，前哨淋巴结活检（SNB）已成为乳腺癌的标准治疗方法，但尚无前瞻性随机试验的结果。我们研究的目的是在多中心、非随机且具有可比组的情况下评估乳腺癌前哨淋巴结活检的肿瘤学安全性。
1996年5月至2004年11月期间，奥地利14个科室的2942例患有单中心、单侧、浸润性疾病且未接受新辅助治疗的患者被纳入数据库。奥地利前哨淋巴结研究组的建议是，先进行一个为期50例前哨淋巴结活检（SNB）的培训阶段（I期），随后进行腋窝淋巴结清扫（ALND），以证明检出率≥90%且假阴性率≤5%。在实施阶段（II期），仅当前哨淋巴结（SN）存在转移时，在前哨淋巴结活检后进行腋窝淋巴结清扫。我们比较了两组在无病生存率、局部复发率、远处复发率和总生存率方面的结果。I期和II期的病例分别产生了第I组（n = 671）和第2组（n = 2271例）。
总体平均随访时间：34.41个月。
仅在前哨淋巴结有转移的情况下在前哨淋巴结活检后进行腋窝淋巴结清扫是一种安全的手术，并且在所有情况下至少与腋窝淋巴结清扫相当。
