10-YEAR RESULTS OF A RANDOMIZED CLINICAL-TRIAL COMPARING RADICAL MASTECTOMY AND TOTAL MASTECTOMY WITH OR WITHOUT RADIATION
10-YEAR RESULTS OF A RANDOMIZED CLINICAL-TRIAL COMPARING RADICAL MASTECTOMY AND TOTAL MASTECTOMY WITH OR WITHOUT RADIATION
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DOI：
10.1056/nejm198503143121102
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发表时间：
1985-01-01
影响因子：
158.5
通讯作者：
FOSTER, R
中科院分区：
文献类型：
--
作者：
FISHER, B;REDMOND, C;FOSTER, R
1971年，一项随机试验开始比较乳腺癌的替代性局部和区域治疗，所有这些治疗都采用乳房切除术。获得了1665名妇女参加研究的平均126个月的寿命表估计。3组腋淋巴结阴性患者在10年无病生存率、无远处转移生存率或总生存率（约57%）方面无显著差异。患者接受根治性乳房切除术，全（简单）乳房切除术不腋窝淋巴结清扫，但区域照射或全乳房切除术不照射加腋窝淋巴结清扫，如果随后淋巴结阳性。临床阳性淋巴结患者行放射状乳腺切除术或不行腋窝淋巴结清扫但行全乳切除术加局部放疗的疗效无差异。两组的10年生存率约为38%。乳腺肿瘤的位置并不影响预后，内象限病变患者的内乳淋巴结照射并不能提高生存率。5年时获得的结果可准确预测10年时的结局。本研究中使用的局部和区域治疗的变化在决定乳腺癌患者的生存率方面并不重要。
In 1971 a randomized trial to compare alternative local and regional treatments of breast cancer, all of which employ breast removal was begun. Life-table estimates were obtained for 1665 women enrolled in the study for a mean of 126 mo. There were no significant differences among 3 groups of patients with clinically negative axillary nodes, with respect to disease-free survival, distant-disease-free survival, or overall survival (about 57%) at 10 yr. The patients were treated by radical mastectomy, total (simple) mastectomy without axillary dissection but with regional irradiation or total mastectomy without irradiation plus axillary dissection only if nodes were subsequently positive. No differnces were observed between patients with clinically positive nodes treated by radial mastectomy or by total mastectomy without axillary dissection but with regional irradiation. Survival at 10 yr was about 38% in both groups. The location of a breast tumor does not influence the prognosis and that irradiation of internal mammary nodes in patients with inner-quadrant lesions does not improve survival. The results obtained at 5 years accurately predict the outcome at 10 years. The variations of local and regional treatment used in this study are not important in determining survival of patients with breast cancer.