腋窝淋巴结清扫术对乳腺癌前哨淋巴结微转移患者预后的影响

Significance of axillary lymph node dissection for breast cancer patients with sentinel lymph node micrometastasis

目的探讨乳腺癌前哨淋巴结微转移患者行腋窝淋巴结清扫术的意义。方法收集2013年1月-2015年12月解放军总医院第一医学中心收治的118例乳腺癌伴前哨淋巴结微转移患者临床资料。根据手术方式分为腋窝淋巴结清扫组(57例)和淋巴结未清扫组(61例),比较两组生存差异。结果两组患者一般资料差异均无统计学意义(P> 0.05)。腋窝淋巴结清扫组和未清扫组的2年总生存率分别为98.18%和98.25%,2年无进展生存率分别为98.18%和96.49%,两组总生存率、无进展生存率差异均无统计学意义(P=0.970,P=0.605)。结论乳腺癌前哨淋巴结微小转移患者可不必行腋窝淋巴结清扫,但应加强术后辅助治疗。

Objective To investigate the significance of axillary lymph node dissection for breast cancer patients with sentinel lymph node micrometastasis.Methods Clinical data about 118 cases of breast cancer with sentinel lymph node micrometastasis from Januany 2013 to December 2015 in the first medical center of Chinese PLA General Hospital were collected.According to the different surgical modes,patients were divided into axillary lymph node dissection group(57 cases)and non-axillary lymph node dissection group(61 cases).Kaplan-Meier analysis was used to analyze the overall survival and progression-free survival in two groups.Results There was no significant difference in general data between the two groups(P>0.05).The 2-year overall survival rates were 98.18%in axillary lymph node dissection group and 98.25%in non-axillary lymph node dissection group,while the 2-year progression-free survival rates were 98.18%in axillary lymph node dissection group and 96.49%in non-axillary lymph node dissection group,without significant difference(P=0.970,P=0.605,respectively).Conclusion Axillary lymph node dissection may be omitted for the patients with isolated tumor cell metastasis and sentinel lymph node micrometastasis,but postoperative adjuvant therapy should be strengthened.