论文部分内容阅读
目的探讨腋窝淋巴结清扫总数(pN tot)对乳腺癌患者预后的影响。方法回顾性分析乳腺癌根治术腋窝淋巴结阴性患者103例的临床资料。电话或门诊随访30~95个月:术后第1年每3个月随访1次,第2年每半年随访1次,第3年以后每年随访1次。随访因患者乳腺癌复发、转移或死亡而终止,对影响患者预后的因素进行单因素和多因素分析。结果随访期间11例死亡,5年生存率为89.32%。单因素分析显示,年龄、TNM分期、pN tot、放疗与否和雌激素受体状态与乳腺癌患者的预后密切相关(P<0.05)。多因素分析发现,TNM分期和pN tot是影响乳腺癌根治术腋窝淋巴结阴性患者的独立预后因素(P<0.05)。pN tot≥15个患者的中位5年生存时间长于pN tot<15个患者(94.3个月vs.80.8个月)(P<0.05)。结论 pN tot是影响淋巴结阴性乳腺癌患者的独立预后因素之一,适当增加术中pN tot能够明显提高乳腺癌患者的生存率。
Objective To investigate the effect of total axillary lymph node dissection (pN tot) on the prognosis of patients with breast cancer. Methods The clinical data of 103 patients with axillary lymph node negative patients undergoing radical mastectomy were retrospectively analyzed. Telephone or outpatient follow-up of 30 to 95 months: 1st follow-up every 3 months in the first year, 1st half-year follow-up in the 2nd year, and 1st follow-up after the 3rd year. Follow-up was terminated due to breast cancer recurrence, metastasis, or death. Univariate and multivariate analyses were performed to determine the factors affecting patient outcomes. Results 11 patients died during follow-up, and the 5-year survival rate was 89.32%. Univariate analysis showed that age, TNM stage, pN tot, radiotherapy and estrogen receptor status were closely related to the prognosis of breast cancer patients (P<0.05). Multivariate analysis found that TNM staging and pN tot were independent prognostic factors affecting axillary lymph node negative patients undergoing radical mastectomy (P<0.05). The median 5-year survival time for pN tot≥15 patients was longer than pN tot<15 patients (94.3 months vs. 80.8 months) (P<0.05). Conclusions pN tot is one of the independent prognostic factors affecting lymph node negative breast cancer. Appropriately increasing pN tot during surgery can significantly increase the survival rate of breast cancer patients.