Asaga T, Masuzuma C, Yoshida A
Department of Surgery, Kanagawa Cancer Center Hospital, Yokohama, Japan.
Nihon Geka Gakkai Zasshi. 1994 Aug;95(8):528-32.
We treated breast cancer patients with Ps node involvement using an extended surgery (Ps+Sc, n = 17, group A) combined with targeting chemotherapy and compared the survival rate by this method with that by the dissection of the Ps node alone (n = 23, group B) to assess the prognosis of advanced breast cancer by extended surgery. 1) Overall patients: The disease-free survival rate was significantly higher in group A, while the overall survival rate was not significant. 2) Survival rate in relation to the number of metastatic Ps nodes or axillary (Ax) nodes: In patients with Ps = 1 or Ax < or = 3, the difference in the overall and disease-free rates were not significant. In patients with Ps > or = 2 or Ax > or = 4, both overall and disease-free rates were significantly higher in group A. It was therefore suggested that extended surgery should be performed if metastasis is found in 2 or more Ps nodes in the frozen section intraoperatively. The result of this study, although it is not a randomized trial, suggested a possibility that extended surgery may improve the prognosis of advanced breast cancer.
我们采用扩大手术（胸肌间淋巴结清扫联合腋窝淋巴结清扫，n = 17，A组）联合靶向化疗治疗有胸肌间淋巴结转移的乳腺癌患者，并将该方法的生存率与单纯胸肌间淋巴结清扫（n = 23，B组）的生存率进行比较，以评估扩大手术对晚期乳腺癌预后的影响。1）总体患者：A组的无病生存率显著更高，而总生存率无显著差异。2）与胸肌间转移淋巴结或腋窝淋巴结数量相关的生存率：在胸肌间淋巴结=1或腋窝淋巴结≤3的患者中，总生存率和无病生存率的差异不显著。在胸肌间淋巴结≥2或腋窝淋巴结≥4的患者中，A组的总生存率和无病生存率均显著更高。因此，建议如果术中冰冻切片发现2个或更多胸肌间淋巴结有转移，应进行扩大手术。本研究结果虽不是随机试验，但提示扩大手术可能改善晚期乳腺癌预后的可能性。
