保乳根治术与全乳房切除术治疗Ⅱ/Ⅲ期乳腺癌的远期生存率随访比较

Long-term survival follow-up of breast-conserving radical mastectomy versus total mastectomy for stage Ⅱ/Ⅲ breast cancer

目的比较保乳根治术与全乳房切除术治疗Ⅱ/Ⅲ期乳腺癌的远期生存率。方法回顾性分析2013年7月至2016年6月137例乳腺癌手术患者临床资料,根据术式不同分为保乳组(n=66例,接受保乳根治术)和全切组(n=71例,接受全乳房切除术)。采用SPSS23.0统计软件进行数据分析。手术相关指标、心理状态、生活质量等计量资料以(x±s)表示,采用独立样本1检验;并发症等计数资料采用X检验。采用Kaplan-Meier进行生存分析,利用Log-Rank检验,评估两组患者术后生存情况。P<0.05为差异有统计学意义。结果保乳组手术时间高于全切组,患者术中出血量、住院时间低于全切组(P<0.05)。术后保乳组患者焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于全切组,健康调查简表(SF-36)评分高于全切组(P<0.05)。两组患者术后并发症总发生率、术后1年、3年、5年复发率和总生存率比较,差异均无统计学意义(P>0.05)。结论与全乳房切除术相比,保乳根治术治疗Ⅱ/Ⅲ期乳腺癌具有一定微创优势,可改善患者心理状态,且并未降低患者远期生存率,也未增加并发症风险,值得临床推广,但应严格控制手术适应证。

Objective To compare the long-term survival rates of breast conserving radical mastectomy and mastectomy for Stage Ⅱ/Ⅲ breast cancer.Methods The clinical data of 137 cases of breast cancer from July 2013 to June 2016 were analyzed retrospectively,According to dfferent surgical methods,they were divided into breast conserving group(n=66 cases,undergoing radical mastectomy)and total mastectomy group(n=71 cases,receiving full mastectomy).SPSS 23.0 statistical analysis software was used for data analysis.Operation Related Index,psychological status,quality of life and other measurement data were expressed by(x±s),independent sample t test was used,X test was used for counting data of complications.Kaplan-Meier survival analysis and Log-Rank test were used to evaluate the survival of the two groups.P<0.05 was considered statistically significant.Results The operation time of breast-conserving group was higher than that f total resection group,and the intraoperative blood loss and hospital stay were lower than those of total resection group(P<0.05).The scores of self-rating Anxiety scale(SAS)and selfrating Depression Scale(SDS)in the breastconserving group were lower than those in the total resection group,and the health Survey Short Form 36(SF-36)score was higher than that in the total resection group(P<0.05).There was no significant dfference in the total incidence of postoperative complications,1,3,5-year recurrence rate and overall survival rate between the two groups(P>0.05).Conclusion Compared with mastectomy,breast conserving radical mastectomy for Stage Ⅱ/Ⅲ breast cancer has cerain minimally invasive advantages,which can improve patients psychological state,does not reduce patients long-lerm survival rale and des not increase the risk of complications.It is worthy of clinical promotion,but the indication of operation should be strictly controlled.