CAJ | 학술논문

目的评估新辅助化疗对腔镜乳腺癌改良根治术患者术后并发症及疗效的影响。方法回顾性分析2007年1月至2010年12月本科收治的183例乳腺癌腔镜手术患者的临床资料,其中98例先接受新辅助化疗再行腔镜乳腺癌改良根治术( NCT组),85例直接行腔镜乳腺癌改良根治术(对照组)。比较两组之间手术情况[手术时间、出血量、引流量、前哨淋巴结活组织检查(简称活检)率及淋巴结转移率],术后并发症(感染、乳头或皮瓣坏死及上肢水肿发生率),以及远期疗效(局部复发率、远处转移率及病死率)的差异,其中,定量资料的比较采用t检验,定性资料的比较采用χ2检验或Fisher确切概率检验。并根据患者随访时间和死亡情况制作累积病死率曲线图。结果 NCT组与对照组间手术时间、出血量、引流量、前哨淋巴结活检率及淋巴结转移方面的差异均无统计学意义( t=-0.381、1.468、-0．725,χ2=1.137、1．022；P=0．704、0.144、0．469、0.286、0.312)。两组患者术后感染(P=0.475)、乳头或皮瓣坏死及上肢水肿发生率(χ2=0.005、1.117,P=0.946、0.291)的差异均无统计学意义。中位随访51个月(9~77个月),两组患者的局部复发率(P=1.000)、远处转移率及病死率(χ2=0.123、0.009,P=0．726、0.925)差异也均无统计学意义。结论新辅助化疗不增加腔镜乳腺癌改良根治术后并发症的发生率,不做新辅助化疗也不影响腔镜乳腺癌改良根治术后的远期疗效。
목적평고신보조화료대강경유선암개량근치술환자술후병발증급료효적영향。방법회고성분석2007년1월지2010년12월본과수치적183례유선암강경수술환자적림상자료,기중98례선접수신보조화료재행강경유선암개량근치술( NCT조),85례직접행강경유선암개량근치술(대조조)。비교량조지간수술정황[수술시간、출혈량、인류량、전초림파결활조직검사(간칭활검)솔급림파결전이솔],술후병발증(감염、유두혹피판배사급상지수종발생솔),이급원기료효(국부복발솔、원처전이솔급병사솔)적차이,기중,정량자료적비교채용t검험,정성자료적비교채용χ2검험혹Fisher학절개솔검험。병근거환자수방시간화사망정황제작루적병사솔곡선도。결과 NCT조여대조조간수술시간、출혈량、인류량、전초림파결활검솔급림파결전이방면적차이균무통계학의의( t=-0.381、1.468、-0．725,χ2=1.137、1．022；P=0．704、0.144、0．469、0.286、0.312)。량조환자술후감염(P=0.475)、유두혹피판배사급상지수종발생솔(χ2=0.005、1.117,P=0.946、0.291)적차이균무통계학의의。중위수방51개월(9~77개월),량조환자적국부복발솔(P=1.000)、원처전이솔급병사솔(χ2=0.123、0.009,P=0．726、0.925)차이야균무통계학의의。결론신보조화료불증가강경유선암개량근치술후병발증적발생솔,불주신보조화료야불영향강경유선암개량근치술후적원기료효。
Objective To evaluate the impact of neoadjuvant chemotherapy ( NCT) on postoperative complications and efficacy after endoscopic mastectomy in breast cancer patients. Methods We retrospectively reviewed the clinical data of 183 breast cancer patients who underwent endoscopic modified mastectomy in our department from January 2007 to December 2010,in which 98 received NCT before surgery ( NCT group) and 85 received endoscopic modified mastectomy directly ( control group ) . The operation data ( operation time, amount of bleeding, amount of drainage, rate of sentinel lymph node biopsy and lymph node metastasis ) , postoperative complications ( infection,necrosis of nipple or skin flap and edema of upper extremities) and long-term efficacy ( local recurrence,rate of distant metastasis and mortality) were compared between two groups. t test was used for measurement data,χ2 test and Fisher’ s exact probability test for count data. Then based on the follow-up time and deaths,the cumulative mortality curves were drawn. Results There were no significant differences in operation time, amount of bleeding, amount of drainage, rate of sentinel lymph node biopsy and lymph node metastasis between two groups(t=-0. 381,1. 468,-0. 725,χ2=1. 137,1. 022;P=0. 704,0. 144, 0.469,0.286,0.312).The rates of postoperative infection(P=0.475),necrosis of nipple or skin flap and edema of upper extremities( χ2=0. 005,1. 117;P=0. 946,0. 291)showed no significantly statistical difference. Median follow-up time was 51 months ( 9-77 months ) . The follow-up showed no significantly statistical difference between two groups in local recurrence(P=1. 000),distant metastasis rate and mortality ( χ2 = <br> 0. 123,0. 009;P=0. 726,0. 925). Conclusion In breast cancer patients,NCT can not increase postoperative complications of endoscopic modified mastectomy,but the long-term efficacy will not be influenced by NCT.