Liu Xu-Hong, Zhang Lei, Chen Bo
Department of Breast Surgery, the First Hospital of China Medical University, Shenyang, Liaoning 110001, China.
Chronic Dis Transl Med. 2016 Feb 19;1(4):236-242. doi: 10.1016/j.cdtm.2016.01.002. eCollection 2015 Dec.
To systematically evaluate the prognosis in patients with breast cancer with ipsilateral supraclavicular lymph node metastasis (SLNM) versus patients with stage IIIb/c or IV breast cancer, so as to provide evidence for clinical practice and research.
Computer retrieval from PubMed, Cochrane Libratory, CNKI (China National Knowledge Infrastructure), CBM and Wanfang Database with the assistance of other retrieval tools. All the studies evaluating the prognosis in patients with breast cancer with ipsilateral supraclavicular lymph node metastasis versus patients with stage IIIb/c or IV breast cancer were collected. Quality assessment was performed for the included data based on the quality assessment criteria appropriate for this study. Meta-analysis was performed using RevMan 5.3 software.
A total of four references (1277 patients) were included. Assessment of influences on prognosis: As compared to the stage IIIb/c group, the 5-year survival rate was slightly lower in the SLNM group (relative risk () 0.79; 95% confidence interval () 0.59-1.06; = 1.55, = 0.12), but there was no statistical significance; in contrast, the 5-year survival rate was significantly increased in the SLNM group as compared to the stage IV group ( = 2.70; 95%: 1.36-5.37; = 2.84, = 0.005). As compared to the stage IIIb/c group, the 5-year disease-free survival rate was lower in the SLNM group ( = 0.65; 95%: 0.40-1.05; = 1.75, = 0.08); however, there was no statistical significance.
In patients with advanced breast cancer receiving combined therapy, the prognosis in patients with breast cancer with ipsilateral SLNM was significantly better than in those with stage IV breast cancer, and slightly worse than those with stage IIIb/c breast cancer. However, with the scarcity and poor quality of these observational studies, the long-term prognosis remains to be further verified in large-sample, high-quality studies.
系统评价同侧锁骨上淋巴结转移（SLNM）的乳腺癌患者与Ⅲb/c期或Ⅳ期乳腺癌患者的预后，为临床实践和研究提供依据。
借助其他检索工具，从PubMed、Cochrane图书馆、中国知网（CNKI）、中国生物医学文献数据库（CBM）和万方数据库进行计算机检索。收集所有评估同侧锁骨上淋巴结转移的乳腺癌患者与Ⅲb/c期或Ⅳ期乳腺癌患者预后的研究。根据适用于本研究的质量评估标准对纳入数据进行质量评估。使用RevMan 5.3软件进行荟萃分析。
共纳入4篇参考文献（1277例患者）。预后影响评估：与Ⅲb/c期组相比，SLNM组的5年生存率略低（相对危险度（RR）0.79；95%置信区间（CI）0.59 - 1.06；P = 1.55，P = 0.12），但无统计学意义；相反，与Ⅳ期组相比，SLNM组的5年生存率显著提高（P = 2.70；95%：1.36 - 5.37；P = 2.84，P = 0.005）。与Ⅲb/c期组相比，SLNM组的5年无病生存率较低（P = 0.65；95%：0.40 - 1.05；P = 1.75，P = 0.08）；然而，无统计学意义。
在接受联合治疗的晚期乳腺癌患者中，同侧SLNM的乳腺癌患者的预后明显好于Ⅳ期乳腺癌患者，略差于Ⅲb/c期乳腺癌患者。然而，由于这些观察性研究的稀缺性和质量较差，长期预后仍有待在大样本、高质量研究中进一步验证。
