Department of surgery/Georges François Leclerc Comprehensive Cancer Care Centre-1 rue Professeur Marion, 21000 Dijon, France.
Br J Cancer. 2013 Nov 26;109(11):2783-91. doi: 10.1038/bjc.2013.658. Epub 2013 Oct 29.
The aim of this study was to assess long-term quality of life (QoL) over a period of 6 years in women with breast cancer (BC) who underwent sentinel lymph node biopsy (SLNB), axillary lymph node dissection (ALND), or SLNB followed by ALND.
The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ)-C30 and the EORTC-QLQ-BR-23 questionnaires were used to assess QoL before surgery, just after surgery, 6, 12 and 72 months later. The longitudinal effect of surgical modalities on QoL was assessed with a mixed model analysis of variance for repeated measurements.
Five hundred and eighteen BC patients were initially included. The median follow-up was 6 years. During the follow-up, 61 patients died. None of the patients of the SLNB group developed lymphedema during follow-up and the relapse rate was similar in the different groups (P=0.62). Before surgery, global health status (P=0.52) and arm symptoms (BRAS) (P=0.99) QoL scores were similar whatever the surgical procedure. The BRAS score (P=0.0001) was better in the SLNB group 72 months after surgery. Moreover, during follow-up, patients treated with SLNB had lower arm symptoms scores than ALND patients and there was no difference for arm symptoms between patients treated with ALND and those treated with SLNB followed by complementary ALND.
Long-term follow-up showed that SLNB was associated with less morbidity than ALND.
本研究旨在评估接受前哨淋巴结活检（SLNB）、腋窝淋巴结清扫术（ALND）或 SLNB 后行 ALND 的乳腺癌（BC）女性患者在 6 年内的长期生活质量（QoL）。
使用欧洲癌症研究与治疗组织生活质量问卷（EORTC-QLQ）-C30 和 EORTC-QLQ-BR-23 问卷在术前、术后即刻、6、12 和 72 个月后评估 QoL。使用重复测量混合模型方差分析评估手术方式对 QoL 的纵向影响。
518 例 BC 患者最初纳入研究。中位随访时间为 6 年。随访期间，61 例患者死亡。SLNB 组无患者发生淋巴水肿，不同组的复发率相似（P=0.62）。术前，无论手术方式如何，总体健康状况（P=0.52）和手臂症状（BRAS）（P=0.99）QoL 评分相似。SLNB 组术后 72 个月 BRAS 评分更好（P=0.0001）。此外，在随访期间，SLNB 治疗组的手臂症状评分低于 ALND 治疗组，而 ALND 治疗组与 SLNB 后行补充 ALND 治疗组之间的手臂症状无差异。
长期随访显示，SLNB 比 ALND 引起的发病率更低。
