广泛切除术与局部切除术治疗乳腺分叶状肿瘤的临床分析

Clinical analysis of wide resection and local excision in treatment of phyllodes tumor local resection

目的观察对比广泛切除术与局部切除术治疗乳腺分叶状肿瘤的临床疗效。方法选取2009年1月~2012年1月于我院就诊的乳腺分叶状肿瘤患者82例,根据治疗方式的不同,分为广泛切除组(n=42)与局部切除组(n=40),广泛切除组患者给予广泛切除术治疗,局部切除组给予局部切除术治疗,对比两组患者的治疗效果。结果局部切除组患者术后12个月外展、前屈、内旋、外旋、摸高高度显著优于广泛切除组(P<0.05);两组患者术后12个月后伸、肌力对比差异无统计学意义(P>0.05);广泛切除组患者的复发率显著低于局部切除组(P<0.05);广泛切除组患者无疾病进展中位生存期显著长于局部切除组(P<0.05);两组患者的5年生存率及中位生存期比较,差异无统计学意义(P>0.05);广泛切除组患者的生命质量显著高于局部切除组(P<0.05)。结论与局部切除术相比,广泛切除术治疗乳腺分叶状肿瘤的复发率更低,预后效果更好,患者的生命质量较高,应在患者情况时尽量选择广泛切除术治疗。

Objective To observe the clinical effect of wide resection and local excision in treatment of phyllodes tumor local resection. Methods 82 cases of phyllodes tumor of the breast from January 2009 to January 2012 in our hospital were selected. According to the different treatment, they were divided into wide resection group （n=42） and local resection group （n=40）. Patients in wide resection group were treated with wide resection, and patients in local resection group received local resection, the treatment effect of the two groups were compared. Results After 12 months of operation, the abduction, flexion, pronation, supination, touch height of local resection group were significantly better than those of resection group （P 〈 0.05）. 12 months after the operation, the extension and muscle strength of the two groups had no significant difference, there was no statistical significance （P 〉 0.05）. The recurrence rate of wide resection was significantly lower than that of local resection group （P 〈 0.05）. The median duration of progression free survival of wide resection group was significantly longer than that of local resection group （P 〈 0.05）. There was no significant difference between the two groups in the 5 year survival rate and the median survival time （P 〉0.05）. The quality of life in the extensive resection group was significantly higher than that in the local resection group （P 〈 0.05）. Conclusion Compared with local excision, recurrence rate of extensive resection in the treatment of phyllodes tumor is lower, the prognosis is better, quality of life of patients is higher. Extensive resection should be performed as far as possible in the patient＇s condition.