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| 三阴性乳腺癌患者新辅助化疗后行保乳手术的可行性分析 |
| 夏坤健1,2,王琳2,唐娜1,郭伟1,李梦琴3,4* |
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(1. 九江学院第二附属医院普通外科, 九江 332005;
2. 南昌大学第二附属医院乳腺外科, 南昌 330006;
3. 九江市第一人民医院乳腺科, 九江 332000;
4. 赣南医科大学附属九江医院乳腺科, 九江 332000
*通信作者) |
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| 摘要: |
| 目的 探讨三阴性乳腺癌（TNBC）患者新辅助化疗（NC）后行保乳手术（BCS）的可行性。方法 以南昌大学第二附属医院2014年6月至2017年6月收治的132例TNBC患者为研究对象，其中62例接受NC后BCS（NC组），70例仅接受传统的标准BCS（对照组）。计算NC组患者的缓解率。比较两组患者的一般临床病理资料，采用Kaplan-Meier法对两组患者的无病生存期进行分析，采用Cox比例风险回归方法分析NC后BCS对TNBC患者无病生存的影响。结果 NC组患者的临床缓解率为96.8%（60/62）。NC组患者的年龄、肿瘤组织学分级、腋窝淋巴结状态、Ki67指数、NC后的肿瘤最大直径与对照组比较差异均无统计学意义（均P＞0.05），NC组脉管内癌栓侵犯的患者比例高于对照组（P＜0.01）。BCS后，NC组的1、3、5年无病生存率分别为100%（62例）、93.5%（58例）、69.4%（43例），平均无病生存期为55.5个月；对照组的1、3、5年无病生存率分别为100%（70例）、95.7%（67例）、72.9%（51例），平均无病生存期为55.6个月。两组无病生存期差异无统计学意义（P＞0.05）。Cox比例风险回归分析显示，NC后BCS不是TNBC患者无病生存的危险因素（HR＝1.133，95% CI 0.600～2.139，P＝0.701）。结论 TNBC患者接受NC后临床缓解率较高，NC后行BCS的治疗策略是切实可行的。 |
| 关键词: 三阴性乳腺癌 新辅助化疗 保乳手术 无病生存期 |
| DOI：10.16781/j.CN31-2187/R.20230307 |
| 投稿时间：2023-06-01修订日期：2023-11-09 |
| 基金项目: |
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| Feasibility of breast-conserving surgery after neoadjuvant chemotherapy for triple-negative breast cancer |
| XIA Kunjian1,2,WANG Lin2,TANG Na1,GUO Wei1,LI Mengqin3,4* |
(1. Department of General Surgery, The Second Affiliated Hospital of Jiujiang College, Jiujiang 332005, Jiangxi, China;
2. Department of Breast Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China;
3. Department of Breast, The First People's Hospital of Jiujiang, Jiujiang 332000, Jiangxi, China;
4. Department of Breast, Jiujiang Hospital, Gannan Medical University, Jiujiang 332000, Jiangxi, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the feasibility of breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NC) for triple-negative breast cancer (TNBC). Methods One hundred and thirty-two TNBC patients who were admitted to The Second Affiliated Hospital of Nanchang University from Jun. 2014 to Jun. 2017 were divided into NC group (62 patients who received NC followed by BCS) and control group (70 patients who received only conventional standard BCS). The response rate was calculated for patients in the NC group. The general clinicopathological data of the 2 groups were compared. The disease-free survival (DFS) of the 2 groups was analyzed using the Kaplan-Meier method, and the effect of NC followed by BCS on the DFS was analyzed using Cox proportional hazards regression method. Results The response rate of patients in the NC group was 96.8% (60/62). There were no differences in age, histological grade, axillary lymph node status or Ki67 index between the 2 groups (all P＞0.05), and the maximum tumor diameter after NC in the NC group was similar to that of the control group (P＞0.05). The ratio of intraventricular cancerous thrombus invasion cases was higher in the NC group than in the control group (P＜0.01). The 1-, 3-, and 5-year DFS rates in the NC group were 100% (62 cases), 93.5% (58 cases), and 69.4% (43 cases), respectively, with a mean of 55.5 months; the 1-, 3-, and 5-year DFS rates in the control group were 100% (70 cases), 95.7% (67 cases), and 72.9% (51 cases), respectively, with a mean of 55.6 months; and there was no difference in DFS between the 2 groups (P＞0.05). Cox proportional hazards regression analysis showed that BCS after NC was not a risk factor for DFS in patients with TNBC (hazard ratio＝1.133, 95% confidence interval 0.600-2.139, P＝0.701). Conclusion The response rate to NC is high in TNBC patients, and the treatment strategy of BCS after NC is feasible. |
| Key words: triple-negative breast cancer neoadjuvant chemotherapy breast-conserving surgery disease-free survival |
