Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer.
Ten-year results of a comparison of conservation with mastectomy in the treatment of stage I and II breast cancer.
复制标题
保留乳房切除术与乳房切除术治疗 I 期和 II 期乳腺癌的十年结果比较。
DOI：
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复制
发表时间：
1995
影响因子：
158.5
通讯作者：
P. Okunieff
中科院分区：
文献类型：
--
作者：
J. Jacobson;D. Danforth;K. Cowan;T. d'Angelo;S. Steinberg;L. Pierce;M. Lippman;A. Lichter;E. Glatstein;P. Okunieff
背景
早期乳腺癌的保乳治疗目前已被广泛接受，但其与乳房切除术的可比性仍存在争议。1979年至1987年，美国国家癌症研究所进行了一项随机、单机构试验，比较了乳房肿瘤切除术、腋窝淋巴结清扫术和放射治疗与乳房切除术和腋窝淋巴结清扫术治疗I期和II期乳腺癌的效果。我们在中位潜在随访10.1年后更新了该试验的结果。
方法
247例临床I期和II期乳腺癌患者被随机分配接受改良根治性乳房切除术或乳房肿瘤切除术、腋窝淋巴结清扫术和放射治疗。实际接受随机分组的237例患者的中位随访时间为10.1年。主要终点为总生存期和无病生存期。
结果
10年时，乳房切除术组的总生存率为75%，而乳房肿瘤切除加放疗组的总生存率为77%（P = 0.89）。接受乳房切除术的患者10年无病生存率为69%，而接受乳房肿瘤切除术加放疗的患者为72%（P = 0.93）。乳腺切除术后10年局部区域复发率为10%，乳房肿瘤切除术加放疗后为5%（P = 0.17），乳腺切除术成功治疗复发后，从分析中删失。
结论
在I期和II期乳腺癌的管理中，乳房肿瘤切除术和放射的乳房保护在10年时提供的结果与乳房切除术相当。
BACKGROUND
Breast-conservation therapy for early-stage breast cancer is now an accepted treatment, but there is still controversy about its comparability with mastectomy. Between 1979 and 1987, the National Cancer Institute conducted a randomized, single-institution trial comparing lumpectomy, axillary dissection, and radiation with mastectomy and axillary dissection for stage I and II breast cancer. We update the results of that trial after a median potential follow-up of 10.1 years.
METHODS
Two hundred forty-seven patients with clinical stage I and II breast cancer were randomly assigned to undergo either modified radical mastectomy or lumpectomy, axillary dissection, and radiation therapy. The 237 patients who actually underwent randomization have been followed for a median of 10.1 years. The primary end points were overall survival and disease-free survival.
RESULTS
At 10 years overall survival was 75 percent for the patients assigned to mastectomy and 77 percent for those assigned to lumpectomy plus radiation (P = 0.89). Disease-free survival at 10 years was 69 percent for the patients assigned to mastectomy and 72 percent for those assigned to lumpectomy plus radiation (P = 0.93). The rate of local regional recurrence at 10 years was 10 percent after mastectomy and 5 percent after lumpectomy plus radiation (P = 0.17) after recurrences successfully treated by mastectomy were censored from the analysis.
CONCLUSIONS
In the management of stage I and II breast cancer, breast conservation with lumpectomy and radiation offers results at 10 years that are equivalent to those with mastectomy.
影响因子：
158.5
作者：
FISHER, B;REDMOND, C;SIDOROVICH, L
通讯作者：
SIDOROVICH, L
影响因子：
158.5
作者：
FISHER, B;BAUER, M;RUSSELL, I
通讯作者：
RUSSELL, I