Comparison of Treatment Outcomes With Breast-conserving Surgery Plus Radiotherapy Versus Mastectomy for Patients With Stage I Breast Cancer: A Propensity Score-matched Analysis
Comparison of Treatment Outcomes With Breast-conserving Surgery Plus Radiotherapy Versus Mastectomy for Patients With Stage I Breast Cancer: A Propensity Score-matched Analysis
复制标题
I 期乳腺癌患者保乳手术加放疗与乳房切除术的治疗结果比较：倾向评分匹配分析
DOI：
10.1016/j.clbc.2018.06.002
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发表时间：
2018-10-01
影响因子：
3.1
通讯作者：
Li, Yexiong
中科院分区：
文献类型：
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作者：
Wang, Jianyang;Wang, Shulian;Li, Yexiong
在本研究中，我们回顾性地比较了在一个大的现实世界中，I期乳腺癌患者的保乳手术（BCS）加放疗（RT）与乳房切除术的结局。为了避免组间分布不均匀造成的偏倚，我们使用倾向评分来调整与肿瘤生物学和治疗相关的因素。结果表明，BCS加RT的优越性相比，乳房切除术.Background：研究保乳手术（BCS）加放疗（RT）的优越性相比，单纯乳房切除术与I期乳腺癌患者在现实世界的设置。患者和方法：回顾性分析了1999年至2014年接受治疗的经组织学证实的I期乳腺癌患者的数据。使用多变量比例风险回归评价结局与治疗选择（BCS + RT vs.乳房切除术）的相关性，并使用倾向评分匹配方法进一步证实。结果如下：在本研究的6137例符合条件的患者中，1296例接受BCS加RT，4841例接受乳房切除术加腋窝淋巴结清扫术（乳房切除术组）。多变量分析显示，与乳房切除术相比，BCS加RT与相似的局部无复发生存率相关，但无远处转移生存率（P = 0.003）和总生存率（P = 0.036）更高。对于1252对使用倾向评分匹配的患者，BCS加RT组的5年总生存率显著更高（99.1% vs. 96.1%; P = .001），无远处转移生存率（97.0% vs. 92.2%; P <0.001）和无病生存率（95.3% vs. 90.2%; P = 0.001）。结论：BCS加RT为符合条件的I期乳腺癌患者提供了比乳房切除术更好的结局，应作为首选治疗方案提供。(C)2018爱思唯尔公司All rights reserved.
In the present study, we retrospectively compared the outcomes of breast-conserving surgery (BCS) plus radiotherapy (RT) versus mastectomy for stage I breast cancer patients in a large real-world setting. To avoid bias from an uneven distribution between groups, we used propensity scores to adjust for factors related to tumor biology and therapy. The results demonstrated the superiority of BCS plus RT compared with mastectomy.Background: To investigate the superiority of breast-conserving surgery (BCS) plus radiotherapy (RT) compared with mastectomy alone for patients with stage I breast cancer in a real-world setting. Patients and Methods: The data from patients with histologically confirmed stage I breast cancer treated from 1999 to 2014 were retrospectively reviewed. The association of outcomes with the choice of treatment (BCS plus RT vs. mastectomy) was evaluated using multivariable proportional hazards regression and further confirmed using propensity score matching methods. Results: Of 6137 eligible patients in the present study, 1296 underwent BCS plus RT and 4841 underwent mastectomy plus axillary lymph node dissection without RT (mastectomy group). Multivariate analysis revealed that BCS plus RT was related to similar locoregional recurrence-free survival but greater distant metastasis-free survival (P = .003) and overall survival (P = .036) compared with mastectomy. For the 1252 pairs of patients matched using propensity score matching, the BCS plus RT groups enjoyed significantly greater 5-year overall survival (99.1% vs. 96.1%; P = .001), distant metastasis-free survival (97.0% vs. 92.2%; P < .001), and disease-free survival (95.3% vs. 90.2%; P = .001) compared with the mastectomy group. Conclusion: BCS plus RT provided better outcomes than mastectomy for eligible patients with stage I breast cancer and should be offered as a preferred treatment option. (C) 2018 Elsevier Inc. All rights reserved.