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肿瘤整形保乳手术的肿瘤学结果:单机构大量病例的长期随访:一项配对队列分析。

Oncological results of oncoplastic breast-conserving surgery: Long term follow-up of a large series at a single institution: A matched-cohort analysis.

作者信息

De Lorenzi F, Hubner G, Rotmensz N, Bagnardi V, Loschi P, Maisonneuve P, Venturino M, Orecchia R, Galimberti V, Veronesi P, Rietjens M

机构信息

Division of Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.

Division of Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.

出版信息

Eur J Surg Oncol. 2016 Jan;42(1):71-7. doi: 10.1016/j.ejso.2015.08.160. Epub 2015 Sep 8.

Abstract

PURPOSE

Oncoplastic surgery is a well-established discipline that combines conserving treatment for breast cancer with immediate plastic reconstruction. Although widely practiced, the oncologic outcomes of this combined approach are reported only in small series. The aim of the present paper is to assess the safety of oncoplastic surgery for invasive primary breast cancer.

METHODS

We compared 454 consecutive patients who underwent an oncoplastic approach between 2000 and 2008 for primary invasive breast tumors (study group) with twice the number of patients who received conservation alone in the same interval time (control group). Disease free survival and overall survival were estimated using the Kaplan-Meier method. The log-rank test was used to assess differences between groups.

RESULTS

The median follow-up was 7.2 years. The overall survival is similar within the two groups, being 91.4% and 91.3% at 10-yr in the study group and in the control group respectively. The disease free survival is slightly lower in the oncoplastic group (69 vs.73.1% at 10-yr). The difference is not statistically significant.

DISCUSSION

We have compared a large series of primary breast cancer patients that have undergone oncoplastic surgery (454) with a control group (908) and they were followed for a prolonged period of time. It provides the best available evidence to suggest that oncoplastic surgery is a safe and reliable treatment option for the managing of invasive breast cancer.

摘要

目的

肿瘤整形手术是一门成熟的学科,它将乳腺癌的保乳治疗与即刻整形重建相结合。尽管该手术已广泛开展,但这种联合治疗方法的肿瘤学结果仅在小样本系列研究中有报道。本文旨在评估肿瘤整形手术治疗原发性浸润性乳腺癌的安全性。

方法

我们比较了2000年至2008年间连续接受肿瘤整形手术治疗原发性浸润性乳腺肿瘤的454例患者(研究组)和在相同时间段内仅接受保乳治疗的患者数量两倍的对照组。采用Kaplan-Meier法估计无病生存率和总生存率。使用对数秩检验评估组间差异。

结果

中位随访时间为7.2年。两组的总生存率相似,研究组和对照组在10年时分别为91.4%和91.3%。肿瘤整形组的无病生存率略低(10年时分别为69%和73.1%)。差异无统计学意义。

讨论

我们将大量接受肿瘤整形手术的原发性乳腺癌患者(454例)与一个对照组(908例)进行了比较,并对他们进行了长期随访。这提供了现有最佳证据,表明肿瘤整形手术是治疗浸润性乳腺癌的一种安全可靠的治疗选择。

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