Volders José H, Negenborn Vera L, Haloua Max H, Krekel Nicole M A, Jóźwiak Katarzyna, Meijer Sybren, M van den Tol Petrousjka
Department of Surgical Oncology, VU University Medical Center, Amsterdam, The Netherlands.
Department of Plastic Surgery, VU University Medical Center, Amsterdam, The Netherlands.
J Surg Oncol. 2017 Jun;115(8):941-948. doi: 10.1002/jso.24615. Epub 2017 Mar 23.
Cosmetic results and quality of life (QoL) are increasingly important in the treatment of breast cancer. This study was designed to determine the relationship between QoL and both subjectively and objectively measured cosmetic outcomes of breast-conserving therapy (BCT), and its course over time.
A total of 128 breast cancer patients who underwent BCT as part of a prospective randomized controlled trial were included. QoL was measured using the EORTC QLQ-C30 and QLQ-BR23 at baseline, 3, 6, 12, and 36 months. Cosmetic outcome was determined by patient self-evaluation, panel evaluation, and BCCT.core software.
By 36 months, all QoL factors except arm symptoms had returned to baseline or improved. After adjustment for patient and tumor characteristics, a significantly better QoL in terms of body image, pain, and arm and breast symptoms was found for good/excellent cosmetic outcomes compared to fair/poor outcomes, as measured by both patient self-evaluation and panel evaluation. The BCCT.core showed no correlation with any QoL factors.
There is a high correlation between poor cosmetic outcome and low scores on quality of life indicators, underlining the importance of achieving a good cosmetic outcome after BCT.
在乳腺癌治疗中，美容效果和生活质量（QoL）愈发重要。本研究旨在确定生活质量与保乳治疗（BCT）主观及客观测量的美容效果之间的关系，以及其随时间的变化过程。
纳入128例作为前瞻性随机对照试验一部分接受保乳治疗的乳腺癌患者。在基线、3个月、6个月、12个月和36个月时，使用欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）和乳腺癌特异性问卷（QLQ-BR23）测量生活质量。美容效果由患者自我评估、专家小组评估和BCCT.core软件确定。
到36个月时，除手臂症状外，所有生活质量因素均恢复至基线水平或有所改善。在调整患者和肿瘤特征后，与一般/差的美容效果相比，通过患者自我评估和专家小组评估发现，在身体形象、疼痛以及手臂和乳房症状方面，良好/优秀的美容效果具有显著更好的生活质量。BCCT.core与任何生活质量因素均无相关性。
美容效果差与生活质量指标得分低之间存在高度相关性，强调了保乳治疗后获得良好美容效果的重要性。
