The dissection of internal mammary nodes does not improve the survival of breast cancer patients. 30-year results of a randomised trial
The dissection of internal mammary nodes does not improve the survival of breast cancer patients. 30-year results of a randomised trial
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DOI：
10.1016/s0959-8049(99)00133-1
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发表时间：
1999-09-01
影响因子：
8.4
通讯作者：
Zucali, R
中科院分区：
文献类型：
--
作者：
Veronesi, U;Marubini, E;Zucali, R
内乳区的淋巴结是引流乳腺淋巴结的主要部位，其切除或放射治疗已成为乳腺癌治疗的重要环节。从1964年1月至1968年1月，737例乳腺癌患者在米兰国家癌症研究所随机接受霍尔斯特德乳房切除术或扩大乳房切除术与内乳淋巴结清扫。分类为T1、T2、T3、N0、N1的非播散性癌患者有资格参加本研究。无患者接受术后放疗或全身治疗。随访30年后，两组患者的总生存曲线和特异性生存曲线均无差异。在30年间隔期内死亡的558例患者中，395例（71%）死于乳腺癌（Halsted组201例，扩大乳房切除术组194例），163例死于其他原因。这项研究表明，内乳淋巴结的切除并不能提高乳腺癌患者的生存率，这一发现支持了区域淋巴结的治疗并不影响癌症患者的生存率的理论。然而，内乳淋巴结状态的预后价值很高，为了分期的目的，应考虑对选定的淋巴结进行活检。(C)1999爱思唯尔科技有限公司。保留所有权利。
The lymph nodes of the internal mammary chairs represent a primary station draining the lymph fi anl the breast and their removal or their irradiation has been considered spa important seep in breast cancer treatment. From January 1964 to January 1968, 737 patients with breast cancer were randomised at the National Cancer Institute in Milan to undergo either Halsted mastectomy or extended mastectomy with internal mammary node dissection. Patients with non-disseminated carcinoma classified as T1, T2, T3, N0, N1 were eligible for the study. No patients received postoperative radiotherapy or systemic therapy. After 30 years of follow-up, the overall survival curves and the specific survival curves do not show any difference between the patients of the two groups. Among the 558 patients who died in the 30 year interval period, 395 (71%) died from breast carcinoma (201 in the Halsted group and 194 in the extended mastectomy group) and 163 from other causes. This study shows that the removal of internal mammary nodes does not improve the survival Of patients treated for breast: carcinoma, This finding supports the theory that treatment of regional nodes does not influence the survival of cancer patients. The prognostic value of internal mammary node status is, however, high and a biopsy on a selected lymph node should be considered for staging purposes. (C) 1999 Elsevier Science Ltd. All rights reserved.