中国和加拿大两所医院乳腺癌病人术后生存分析比较

Comparison of survival among patients with breast cancer treated at First Teaching Hospital,Changchun,China and at Saint-Sacrement Hospital,Quebec,Canada

目的 :探讨我国北方地区乳腺癌病人的 5年生存率、主要预后因素及其与加拿大类似气候地区的异同。方法 :收集吉林大学第一医院 (中国长春 ,简称 FTH)和拉瓦尔大学圣萨可门医院 (加拿大魁北克 ,简称 SSH) 10 0 2例乳腺癌病人的资料 ,包括自然状况及预后因素 (经历史性队列研究 ) ,采用Kaplan- Meier方法计算生存指标 ,并进行分层比较。结果 :病人的平均年龄 FTH较 SSH小 10岁( P<0 .0 0 0 1) ;病人原发肿瘤大小差异有显著性 ( P=0 .0 36) ;腋窝淋巴结有转移病人的比例 FTH明显地高于 SSH( P<0 .0 0 0 1) ;手术方式 FTH多为乳腺癌改良根治术 ,SSH则对 、 期病人首选局部切除 ;病人术后 5年生存率 :FTH为 74 .2 % ,SSH为 76.3% ,差异不显著 ( P=0 .30 2 )。结论 :尽管两所医院病人的就诊年龄、肿瘤大小、淋巴结转移个数有不同 ,但其 5年生存率却无显著性差异。

Objective:To explore th five year survivals and some prognostic factors for bresat cancer patients in the north areas of China,and the indentification or differences on these variables among breast cancer patients between in China and in Canada.Methods:All Data were collected from the hospital records of 1 002 breast cancer patients who were initially treated at the First Hospital of Jilin University (116 cases FTH,Changchun China) and the Saint-Sacrement Hospital (886 cases in SSH,Quebec Canada) respectively by use of Historical Cohort survey,and the survival propotions were calculated and compared stradly by use of Kaplan-Meier method.Results:Age at diagnosis was substantially lower (average of age about 10 years less) among breast cancer patients seen at FTH compared to those treated at SSH ( P <0 0001).Patients in the two hospitals differed in respect to tumor size at pathology ( P =0 036).The proportion of women with lymph node involvement was greater at FTH (61.1%) than that at HSS(37.3%)( P <0 0001).Surgical treatment of breats cancer was varied considerably:the radical mastectomy was frequently performed for andy stage of breast cancer patients in Changchun,but the partial mastectomy was mainly used for patients with stage Ⅰ or Ⅱ in Quebec.The five year survival was 74.2% among breast cacer patients seen at FTH compared to 76.3% among women treated at HSS,and there was no singnificant differrence ( P =0 302).Conclusion:Five year survival of breast cancer patients treated surgically in Changchun,China,was similar to that of patients treated surgically in Quebec,Canada except for differences in age at diagnosis,tumor size and lymph node involvement [