| 摘要: |
| 目的 探讨保乳手术对年轻乳腺癌患者的临床疗效。方法 以南昌大学第二附属医院2012年2月至2017年2月收治的208例年轻（年龄≤35岁）乳腺癌患者为研究对象，根据手术方式分为保乳手术组（n=64）与改良乳腺癌根治术组（n=144）。采用Mann-Whitney U检验分析两组患者的术中出血量、术后引流量以及住院时间的差异。采用Kaplan-Meier法对两组患者的无病生存期进行分析。采用单因素及多因素Cox比例风险回归模型分析保乳手术治疗对年轻乳腺癌患者无病生存期的影响。结果 保乳手术组患者的术中出血量、术后引流量均少于改良乳腺癌根治术组（P均＜0.05），住院时间短于改良乳腺癌根治术组（P＜0.05）。保乳手术组患者的无病生存期短于改良乳腺癌根治术组（55.3个月vs 58.1个月，P=0.001）。多因素Cox比例风险回归模型分析显示，保乳手术治疗（HR=3.090，95% CI 1.498～6.371，P=0.002）、肿瘤组织学分级（Ⅲ级）（HR=4.572，95% CI 1.055～19.813，P=0.042）、三阴性乳腺癌（HR=4.302，95% CI 1.142～16.212，P=0.031）为年轻乳腺癌患者无病生存期的独立危险因素。结论 保乳手术对年轻乳腺癌患者具有创伤小、住院时间短等优点，但保乳手术的预后较改良乳腺癌根治术差，应持谨慎态度。 |
| 关键词: 青年人 乳腺肿瘤 保乳手术 无病生存期 Cox回归 |
| DOI：10.16781/j.CN31-2187/R.20220690 |
| 投稿时间：2022-08-26修订日期：2023-03-07 |
| 基金项目: |
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| Breast-conserving surgery in young patients with breast cancer: a clinical analysis of effectiveness |
| XIA Kunjian1,2△,HUANG Jialiang1△,SUN Zhenhua1*,WANG Lin2,LI Ding2,GUO Wei1 |
(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
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To explore the clinical effect of breast-conserving surgery on young patients with breast cancer. Methods A total of 208 young breast cancer patients (age≤35 years) who were admitted to The Second Affiliated Hospital of Nanchang University from Feb. 2012 to Feb. 2017 were enrolled and divided into breast-conserving group (n=64) and modified radical mastectomy group (control group, n=144). The Mann-Whitney U test was used to analyze the differences in the intraoperative blood loss, postoperative drainage, and hospital stay between the 2 groups. The Kaplan-Meier method was used to analyze the disease-free survival (DFS) of the 2 groups. Univariate and multivariate Cox proportional hazards regression models were used to analyze the effect of breast-conserving therapy on DFS of young breast cancer patients. Results The intraoperative blood loss and postoperative drainage of patients in the breast-conserving group were significantly less than those in the control group (both P＜0.05), and the hospital stay was significantly shorter than that in the control group (P＜0.05). The DFS of the breast-conserving group was significantly shorter than that of the control group (55.3 months vs 58.1 months, P=0.001). Multivariate Cox proportional hazards regression model analysis showed that breast-conserving therapy (hazard ratio [HR］＝3.090, 95% confidence interval[CI］1.498-6.371, P=0.002), histological grading of tumor (Ⅲ) (HR=4.572, 95% CI 1.055-19.813, P=0.042), and triple negative breast cancer (HR=4.302, 95% CI 1.142-16.212, P=0.031) were independent risk factors of DFS in young breast cancer patients. Conclusion Breast-conserving surgery has the advantages of less trauma and shorter hospital stay in young patients with breast cancer, but the prognosis of the breastconserving surgery is worse than that of the modified radical mastectomy. Therefore, young breast cancer patients have to make their choice carefully. |
| Key words: young adult breast neoplasms breast-conserving surgery disease-free survival Cox regression |
