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保乳手术后与传统乳房切除术相比,患者的局部、区域和全身复发率。

Local, regional, and systemic recurrence rates in patients undergoing skin-sparing mastectomy compared with conventional mastectomy.

机构信息

Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.

出版信息

Cancer. 2011 Mar 1;117(5):916-24. doi: 10.1002/cncr.25505. Epub 2010 Oct 13.

Abstract

BACKGROUND

Although the use of SSM is becoming more common, there are few data on long-term, local-regional, and distant recurrence rates after treatment. The purpose of this study was to examine the rates of local, regional, and systemic recurrence, and survival in breast cancer patients who underwent skin-sparing mastectomy (SSM) or conventional mastectomy (CM) at our institution.

METHODS

Patients with stage 0 to III unilateral breast cancer who underwent total mastectomy at our center from 2000 to 2005 were included in this study. Kaplan-Meier curves were calculated, and the log-rank test was used to evaluate the differences between overall and disease-free survival rates in the 2 groups.

RESULTS

Of 1810 patients, 799 (44.1%) underwent SSM and 1011 (55.9%) underwent CM. Patients who underwent CM were older (58.3 vs 49.3 years, P<.0001) and were more likely to have stage IIB or III disease (53.0% vs 31.8%, P<.0001). Significantly more patients in the CM group received neoadjuvant chemotherapy and adjuvant radiation therapy (P<.0001). At a median follow-up of 53 months, 119 patients (6.6%) had local, regional, or systemic recurrences. The local, regional, and systemic recurrence rates did not differ significantly between the SSM and CM groups. After adjusting for clinical TNM stage and age, disease-free survival rates between the SSM and CM groups did not differ significantly.

CONCLUSIONS

SSM is an acceptable treatment option for patients who are candidates for immediate breast reconstruction. Local-regional recurrence rates are similar to those of patients undergoing CM. Cancer 2011. © 2010 American Cancer Society.

摘要

背景

虽然乳房保留手术(SSM)的应用越来越普遍,但关于治疗后局部、区域和远处复发率的数据却很少。本研究的目的是检查在我们机构接受皮肤保留乳房切除术(SSM)或传统乳房切除术(CM)的乳腺癌患者的局部、区域和全身复发率及生存率。

方法

本研究纳入了 2000 年至 2005 年在我院行全乳切除术的 0 期至 III 期单侧乳腺癌患者。通过 Kaplan-Meier 曲线计算,对数秩检验评估两组总生存率和无病生存率的差异。

结果

在 1810 例患者中,799 例(44.1%)行 SSM,1011 例(55.9%)行 CM。CM 组患者年龄更大(58.3 岁比 49.3 岁,P<.0001),且 IIB 期或 III 期疾病的比例更高(53.0%比 31.8%,P<.0001)。CM 组接受新辅助化疗和辅助放疗的患者明显更多(P<.0001)。中位随访 53 个月时,119 例(6.6%)患者发生局部、区域或全身复发。SSM 和 CM 组的局部、区域和全身复发率无显著差异。调整临床 TNM 分期和年龄后,SSM 和 CM 组的无病生存率无显著差异。

结论

SSM 是适合即刻乳房重建患者的可接受治疗选择。局部区域复发率与行 CM 患者相似。癌症 2011. © 2010 美国癌症协会。

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