Physical function of the upper limb after breast cancer surgery. Results from the SOUND (Sentinel node vs. Observation after axillary Ultra-souND) trial
Physical function of the upper limb after breast cancer surgery. Results from the SOUND (Sentinel node vs. Observation after axillary Ultra-souND) trial
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DOI：
10.1016/j.ejso.2016.01.020
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发表时间：
2016-05-01
期刊：
影响因子：
3.8
通讯作者：
Veronesi, U.
中科院分区：
文献类型：
--
作者：
Gentilini, O.;Botteri, E.;Veronesi, U.
背景：Sound(前哨淋巴结与腋窝超声后观察)试验是一项正在进行的前瞻性随机研究，比较腋窝超声检查阴性的小乳腺癌前哨淋巴结活检与无腋窝手术分期的患者。患者和方法：首先招募的180名患者在不同的时间点(术前、术后1周、6个月和1年)接受QuickDASH(残疾手臂和肩膀)问卷调查，以评估同侧上肢的身体功能。QuickDASH评分范围从0(无残疾)到100(完全残疾)。结果：176例患者进入分析，其中SNB组94例，观察组82例。两组在年龄、肿瘤特征和治疗方面具有可比性。术前SNB组和观察组的评分值分别为3.0%和2.7%(P=0.730)。术后1周，SNB组和观察组的评分分别为24.0%和10.6%(P<；0.001)。在6个月和12个月后，两个手臂的得分下降到与基准值相似的值。两组患者在时间上的总体趋势有显著差异(P<；0.001)，即使排除了5名在SNB接受AD治疗的患者(P<；0.001)。结论：接受SNB治疗的患者在术后早期的致残率显著高于未接受SNB治疗的患者。瑞士央行的回避可能会相当大程度上减少身体和精神上的痛苦。(C)2016爱思唯尔有限公司。保留所有权利。
Background: The SOUND (Sentinel node vs. Observation after axillary Ultra-souND) trial is an ongoing prospective randomized study comparing sentinel node biopsy vs. no axillary surgical staging in patients with small breast cancer and negative pre-operative ultra-sound of the axilla.Patients and methods: The first 180 recruited patients were administered the QuickDASH (Disability Arm and Shoulder) questionnaire at different time points (before surgery, 1 week, 6 months and 1 year after surgery) to evaluate the physical function of the ipsilateral upper limb, The QuickDASH score ranges from 0 (no disability) to 100 (complete disability).Results: 176 patients were available for analysis (94 in SNB arm and 82 in observation arm). The two groups were comparable with respect to age, tumor characteristics and treatments. Pre-surgery score values were 3.0% and 2.7% in the SNB arm and observation arm, respectively (P = 0.730). One week after surgery, the score increased to 24.0% in the SNB arm and 10.6% in the observation arm (P < 0.001). After 6 and 12 months, the score decreased in both arms to values similar to baseline values. The overall trend in time of the score was significantly different between the two arms (P < 0.001), even after the exclusion of five patients who received AD in the SNB arm (P < 0.001).Conclusions: Patients who underwent SNB had a significantly higher rate of disability in the early post-operative period compared to patients who did not. The avoidance of SNB might translate into a considerable reduction of physical and emotional distress. (C) 2016 Elsevier Ltd. All rights reserved.