改良根治术与保乳手术治疗早期乳腺癌患者的近远期疗效对照比较

Comparative study of short-term and long-term clinical outcome of modified radical mastectomy and breast conserving surgery in treating early staging breast cancer

目的比较改良根治术与保乳手术治疗早期乳腺癌患者的近远期疗效。方法收集2011年6月至2014年1月早期乳腺癌的患者134例,采用随机数字表法将其分为根治组与保乳组,分别采用改良根治术与保乳手术进行治疗,采用SPSS19. 0软件进行分析,术中术后指标和生活质量评分采用均数±标准差进行描述,采用独立t检验; 1年和3年总生存率和无病生存率、并发症采用率进行描述,采用χ2检验;采用log-rank检验法对两组患者的生存率进行检验,检验水准为α=0. 05。结果根治组患者术中的平均出血量低于保乳组,且手术时间和术后的平均住院天数均少于保乳组,根治组患者的生理职能和精神健康得分低于保乳组,差异均具有统计学意义(P <0. 05);根治组患者的3年无病生存率和3年总生存率均高于保乳组(P <0. 05);根治组患者的腋窝淋巴结转移率低于保乳组,差异具有统计学意义(P <0. 05)。结论改良根治术治疗早期乳腺癌患者的近期疗效和远期疗效均优于保乳手术,腋窝淋巴结的转移率低于保乳手术,更为安全有效,推荐在临床上使用。

Objective To compare the short-term and long-term clinical outcome of modified radical mastectomy and breast conserving surgery in treating early staging breast cancer. Methods 134 patients with early staging breast cancer were enrolled into this study,including radical group and breast conserving group by using random number table method.Clinical data were analyzed by using statistical software SPSS 19.0.Measurement data such as perioperative indicators and life quality score were expressed as mean±standard deviation,and independent t test was used for comparison between the groups.Count data,such as 1 year-,3 year-OS/DFS and postoperative complication rate were examined by usingχ2 and log-rank test(α=0.05).A P value<0.05 was considered as statistically significant difference. Results The average blood loss in the radical group was lower than that in the breast conserving group,and the operation time and the average postoperative hospital stay were less than those in the breast conserving group,the scores of physiological function and mental health in the radical group were lower than those in the breast conserving group,with significant differences(P<0.05);the 3-year disease-free survival rate and the 3-year overall survival rate in the radical group were higher than those in the breast conserving group,with significant differences(P<0.05);the axillary lymph node metastasis rate in the radical group was lower than that in the breast conserving group,with significant difference(P<0.05). Conclusion The short-term and long-term clinical outcome of modified radical mastectomy for breast cancer patients are better than breast conserving surgery,the axillary lymph node metastasis rate is lower than the breast conserving surgery.It is safer and more effective and worth of clinical promotion.