ACOSOG Z0011试验结果对中国乳腺外科医生临床实践影响的调查

A Survey of Chinese Breast Surgeons' Response in Clinical Practice to ACOSOG Z0011 Trial

目的了解我国乳腺外科医生对于美国外科医师学会肿瘤学组(American College of Surgeons Oncology Group,ACOSOG)Z0011试验的认知情况,分析Z0011试验结果对中国乳腺外科医生外科实践的影响程度。方法通过问卷调查的方式调查中国乳腺外科医生对Z0011试验的了解情况以及在知道Z0011试验结果前后对于符合Z0011试验入组标准的乳腺癌患者腋窝处理方式的意见并分析相关因素。结果回馈调查问卷的427位医生中有116人(27.2%)对Z0011试验熟悉,不知道的有122人(28.5%)。在知晓Z0011试验结果的305位医生中,在知晓前后,对于符合Z0011试验入组标准的乳腺癌患者,不倾向于做腋窝淋巴结清扫术(axillary lymph node dissection,ALND)的医生分别为78人(25.6%)和115人(37.7%)。医生所属医院的级别、所在地区、受教育程度、从事专业的时间与医生对Z0011试验了解程度之间都存在显著性关系(P<0.05),而与医生在知道Z0011试验结果之后的外科策略选择之间没有相互性关系(P>0.05)。结论我国乳腺外科医生对Z0011试验的认知程度及接受程度仍较低。

Objective To investigate Chinese breast surgeons＇ awareness of the American College of Surgeons Oncology Group（ACOSOG） Z0011 trial and evaluate the impact of Z0011 trial on their surgical practice.Methods A survey was sent by e-mail to Chinese breast surgeons.Questions assessed the respondents＇ familiarity with Z0011 trial and preferences for treating patients fulfi lling the Z0011 criteria.Factors associated with the surgeon＇s awareness of Z0011 and surgical practice pattern were also analyzed.Results The survey was completed by 427 surgeons,116（27.2%） of respondents indicated familiar with Z0011 and 122（28.5%） hadn＇t heard of it.Among the 305 surgeons knowing Z0011,78（25.6%） and 115（37.7%） preferred omitting axillary lymph node dissection（ALND） for patients fulfi lling Z0011 criteria before and after learning of Z0011 results,respectively.The grade and region of the hospital each surgeon practiced in,surgeon＇s degree and practice duration were correlated with their familiarity with Z0011（P〈0.05） but didn＇t associated with their surgical practice after knowing Z0011 trial results（P〉0.05）.Conclusion Most surgeons indicate familiarity with Z0011 and would not incorporate Z0011 into practice in China.