Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection.
Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection.
复制标题
DOI：
10.1002/jso.21535
复制
发表时间：
2010-08-01
影响因子：
2.5
通讯作者：
Wolmark, Norman
中科院分区：
文献类型：
--
作者：
Ashikaga, Takamaru;Krag, David N.;Land, Stephanie R.;Julian, Thomas B.;Anderson, Stewart J.;Brown, Ann M.;Skelly, Joan M.;Harlow, Seth P.;Weaver, Donald L.;Mamounas, Eleftherios P.;Costantino, Joseph P.;Wolmark, Norman
在NSABP B-32试验中，比较了单纯前哨淋巴结清扫阴性（SLND）患者与前哨淋巴结清扫阴性和腋窝淋巴结清扫阴性（ALND）患者的术后3年发病率水平。共有1975例ALND和2008例SLND淋巴结阴性乳腺癌患者进行了肩部活动范围和手臂体积评估，沿着手臂刺痛和麻木的自我报告。计算同侧和对侧手臂之间的相对肩外展缺陷和相对手臂体积差异。ALND组（75%）和SLND组（41%）的肩关节外展缺陷≥ 10%在1周时达到峰值。ALND组（14%）和SLND组（8%）在36个月时的臂体积差异≥ 10%。ALND组（49%，23%）和SLND组（15%，10%）的麻木和刺痛在6个月时达到峰值。Logistic回归分析显示，治疗组、年龄、利手、肿瘤大小、全身化疗和腋窝放疗是影响剩余发病率的相关因素。尽管两个治疗组的剩余发病率都很明显，但NSABP B-32研究的结果表明，在3年随访期内，SLND的术后发病率结局优于ALND治疗方法。
Three year post-surgical morbidity levels were compared between patients with negative sentinel lymph node dissection alone (SLND) and those with negative sentinel node dissection and negative axillary lymph node dissection (ALND) in the NSABP B-32 trial. A total of 1975 ALND and 2008 SLND node negative breast cancer patients had shoulder range of motion and arm volumes assessed along with self reports of arm tingling and numbness. Relative shoulder abduction deficits and relative arm volume differences between ipsilateral and contralateral arms were calculated. Shoulder abduction deficits ≥ 10% peaked at one week for the ALND (75%) and SLND (41%) groups. Arm volume differences ≥ 10% at 36 months were evident for the ALND (14%) and SLND (8%) groups. Numbness and tingling peaked at 6 months for the ALND (49%, 23%) and SLND (15%, 10%) groups. Logistic regression correlates of residual morbidity included treatment group, age, handedness, tumor size, systemic chemotherapy and radiation to the axilla. Although residual morbidity for both treatment groups was evident, the results of the NSABP B-32 study indicate the superiority of the SLND compared to the ALND treatment approach relative to post-surgical morbidity outcomes over a three year follow-up period.
登录
查看更多内容
影响因子：
3.8
作者：
Del Bianco, P.;Zavagno, G.;De Salvo, G. L.
通讯作者：
De Salvo, G. L.
影响因子：
45.3
作者：
Purushotham, AD;Upponi, S;Duffy, SW
通讯作者：
Duffy, SW
影响因子：
3.7
作者：
Krag, DN;Julian, TB;Wolmark, N
通讯作者：
Wolmark, N
影响因子：
158.5
作者：
Veronesi, U;Paganelli, G;Gennari, R
通讯作者：
Gennari, R
影响因子：
51.1
作者：
Krag, David N.;Anderson, Stewart J.;Wolmark, Norman
通讯作者：
Wolmark, Norman