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投稿时间：2020-12-28 网络发布日期：2021-08-20
投稿时间：2020-12-28 网络发布日期：2021-08-20
中文摘要: 目的 探索保乳术和乳房切除术对不同淋巴结转移状况的T1期三阴性乳腺癌(TNBC)患者总体生存期(OS)的影响,为临床决策提供依据。方法 提取监测、流行病学和结果数据库(SEER数据库)中2010年至2014年的T1期非远处转移性TNBC患者的临床病理资料,根据手术方式分为保乳组和切除组。利用倾向评分匹配(PSM)方法平衡混杂因素。采用Cox回归分析不同临床病理因素对TNBC患者生存的影响;采用Kaplan-Meier 法计算OS,采用Log-rank法分析两组总体生存率的差异。结果 本研究共纳入2 082例患者,在PSM控制混杂因素后,共筛选出838例患者,其中保乳组及切除组均为419例,两组基线特征比较差异无统计学意义(P>0.05)。PSM后,多因素Cox回归分析显示,年龄、肿瘤分期、手术方式、化疗是影响患者OS的独立因素(P<0.05,P<0.01)。PSM后生存曲线显示,保乳组2年生存率为96.8%,5年生存率为86.9%;切除组2年生存率为93.1%,5年生存率为81.8%。PSM后Ⅰ期中保乳组患者的生存率高于切除组(P<0.01);ⅡA期和ⅢA/C期中两组生存率比较差异无统计学意义(P=0.17,P=0.54)。结论 年龄、肿瘤分期、手术方式、化疗是T1期TNBC患者OS的独立影响因素。不论局部腋窝淋巴结分期情况,保乳术和乳房全切术两种术式对于T1期TNBC患者一样安全有效。对于Ⅰ期TNBC患者,保乳术能使其从OS中获益。
中文关键词: 三阴性乳腺癌 保乳术 乳房切除术 SEER数据库 倾向性评分匹配；生存期
Abstract:Objective To explore the effect of breast-conserving surgery and mastectomy on the overall survival (OS) of T1 triple negative breast cancer (TNBC) patients with different metastasis status of lymph node,and to provide a basis for clinical decision-making.Methods The clinicopathological data of T1 non-distant metastatic TNBC patients from 2010 to 2014 in the surveillance,epidemiology and results database (SEER database) were extracted and divided into breast-conserving group and mastectomy group according to the surgical method.The propensity score matching (PSM) method was used to balance confounding factors.The Cox regression method was used to analyze the effect of different clinicopathological factors on the survival of T1 TNBC patients;the Kaplan-Meier method was used to calculate the OS,and the Log-rank method was used to analyze the difference in overall survival between two groups.Results A total of 2 082 patients were enrolled in this study.After PSM controlled confounding factors,a total of 838 patients were screened out,of which 419 were in breast-conserving group and mastectomy group.There was no statistically significant difference in baseline characteristics between the two groups (P>0.05).After PSM,multivariate Cox regression analysis showed that age,tumor stage,surgical method,and chemotherapy were independent factors that affect the patient′s OS (P<0.05,P<0.01).The survival curve showed that the 2-year and 5-year survival rate in the breast-conserving group was 96.8% and 86.9%,in the mastectomy group was 93.1% and 81.8%.The survival rate of the breast-conserving group was significantly higher than that of the mastectomy group in stage I(P<0.01);There was no significant difference in survival rate between the two groups in stage ⅡA and ⅢA/C (P=0.17,P=0.54).conclusions Age,tumor stage,surgical methods,and chemotherapy are independent influence factors of OS in T1 TNBC patients.Regardless of the local axillary lymph node staging,breast-conserving surgery and mastectomy are equally safe and effective for patients with T1 stage TNBC.For patients with stage I TNBC,breast-conserving surgery can benefit them from OS.
keywords: Triple-negative breast cancer Breast-conserving surgery Mastectomy SEER database Propensity score matching Overall survival
文章编号： 中图分类号：R737.9 文献标志码：A
基金项目:
| Author Name | Affiliation |
| WANG Song,DENG Jian,LYU Hong-ying,QUAN Yi | Department of Breast Surgery,Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China |
引用文本：
王宋，邓建，吕红英，等.基于SEER数据库分析保乳术和乳房切除术对不同淋巴结转移状况的T1期三阴性乳腺癌预后的影响[J].中国临床研究,2021,34(8):1014-1018.
王宋，邓建，吕红英，等.基于SEER数据库分析保乳术和乳房切除术对不同淋巴结转移状况的T1期三阴性乳腺癌预后的影响[J].中国临床研究,2021,34(8):1014-1018.