早期乳腺癌患者保乳手术与改良根治术的疗效分析

Clinical Research of Reserved Mastectomy and Modified Radical Mastectomy in Treating Breast Cancer

目的探讨早期乳腺癌患者保乳手术与改良根治术的疗效。方法前瞻性研究比较我院2006年至2009年行保乳治疗组(保乳手术+术后放疗)与改良根治术组的临床疗效。将108例患者随机分为两组接受治疗,所有患者随访5年,至2014年12月,对患者的临床疗效及预后进行分析。结果两组患者手术时间、术中出血量、术后并发症发生率,术后生存质量,保乳组明显优于对照组,差异具有统计学意义。保乳组与改良根治术组的5年局部复发率分别为8.9%和8.5%,两者远处转移率分别为9.6%和9.3%,差异无统计学意义。生存分析显示:改良根治术组的5年总生存率(OS)为96.3%,与保乳组的92.9%比较差异无统计学意义(P=0.611)。5年无病生存率(DFS)改良根治术组为80.0%,而保乳组为88.1%,两者有显著性差异(P<0.001)。结论早期乳腺癌保乳治疗后总生存率、局部复发率与改良根治术患者无差异,但保乳手术患者的生存质量明显提高。

Objective To investigate the effect of reserved mastectomy and modified radica1 mastectomy in treating breast cancer.Methods The 108 patients with breast cancer in our hospital in2006~2009 were divided into the observe group and the control group.The control group received the modified radica1 mastectomy,and the observe group received the reserved mastectomy.All patients were followed-up in 5 years.Results The operation time and hemorrhage in operation in the observe group were fewer than those in the control group,and there were significant difference between them（P〈0.05）.The scores of body,psychological,society and consciousness in the observe group were more than those in the control group,and there were significant difference between them（P〈0.05）.The relapse rate of part,distant transfusion rate,survival rate of 5 years in the observe group were the same to those in the control group,and there were no significant difference between them（P〉0.05）.Conclusion Treatment of early breast cancer,breast-conserving therapy and modified radical mastectomy was no difference in overall survival,local recurrence rate,but breast-conserving surgery significantly improved the quality of life of patients.