摘要
目的 探讨乳腺癌根治或改良根治术后腋窝淋巴结清扫和检测的彻底程度对预后的影响和对放射治疗的指导意义。方法 回顾性分析 2 11例乳腺癌接受根治性手术治疗、术后合并或不合并化疗 +放射治疗的病例。根据腋窝淋巴结清扫和检测个数分为 2个组 ,A组 81例 (腋窝淋巴结个数 <10个 ) ,B组 130例 (腋窝淋巴结个数≥ 10个 )。观察 2个组的局部区域复发率和生存率有无显著性差异。结果 A组和B组淋巴结转移数≥ 4个的病例分别占 2 1.0 %和 35 .4% (P =0 .0 2 6 )。A组和B组局部区域复发率分别为 33.3 %和 2 0 .8% (P =0 .0 42 )。淋巴结阴性和转移数为 1～ 3个的局部区域复发率A组为 2 9.7% ,B组为 15 .5 % ,差别有显著性意义 (P =0 .0 37)。A组腋窝淋巴结阴性及淋巴结阳性患者的远地转移率分别为 16 .7%和 31.6 % (P =0 .16 9) ,5年无瘤生存率分别为 6 2 .5 %和 45 .6 % (P =0 .2 5 3) ,5年总生存率分别为 70 .8%和 5 7.9% (P =0 .2 5 3) ,差异均无显著性意义。B组淋巴结阴性及淋巴结阳性患者的远地转移率分别为 5 .9%和 38.0 % (P =0 .0 0 0 ) ,5年无瘤生存率分别为 82 .4%和 5 0 .6 % (P =0 .0 0 0 ) ,5年总生存率分别为 92 .2 %和 6 3 .3% (P =0 .0 0 0 ) ,差异均有显著性意义。结论 腋窝淋巴结清扫和?
Objective To evaluate the effect of extent of dissection in number of positive axillary lymph nodes detected as an indication of postoperative radiotherapy in breast cancer. Methods Between 1983 and 1984, 211 breast cancer patients who received radical or modified radical mastectomy with or without radiotherapy and/or chemotherapy were analyzed retrospectively. According to the number of axillary lymph nodes detected, these patients were subclassified into two groups;the number of axillary lymph nodes < 10 in 81 patients (Group A) and ≥10 in 130 patients (Group B). Difference in locoreginal recurrence, distant recurrence and survival were analyzed in the two groups. Results The incidence of patients with 4 or more positive lymph nodes were 21.0% in Group A and 35.4% in Group B (P=0.026). Their locoreginal recurrence rates were 33.3 % for Group A and 20.8% for Group B,of which the difference was significant (P=0.042). For patients with 0～3 positive lymph nodes, the locoreginal recurrence rates were 29.7% for Group A and 15.5% for Group B, respectively (P=0.037). For patients with negative lymph nodes and patients with positive ones, distant recurrence rates were 16.7% and 31.6% in group A (P=0.169) and 5.9% and 38.0% in group B (P= 0.000 ). The corresponding 5 year disease free survival rates were 62.5% and 45.6% for Group A (P=0.253) and 82.4% and 50.6% for Group B (P= 0.000 ). On the other hand, the overall 5 year survival rates were 70.8% for patients with negative lymph nodes and 57.9% for those with positive lymph nodes in Group A (P= 0.253 ), and 92.2% and 63.3% (P=0.000) in group B.Conclusions Incomplete examination and dissection of axillary lymph nodes underestimate the extent of axillary lymph node metastasis. For patients with less than 10 positive axillary nodes, we suggest postoperative radiotherapy for those with 1～3 positive lymph nodes.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2001年第3期148-152,共5页
Chinese Journal of Radiation Oncology
关键词
乳腺肿瘤
外科手术
放射治疗
淋巴结清扫术
预后
Breast neoplasms/surgery
Breast neoplasms/radiotherapy
Lymphnode dissection
Prognosis
