Using loco-regional recurrence as an indicator of the quality of breast cancer treatment
Using loco-regional recurrence as an indicator of the quality of breast cancer treatment
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DOI：
10.1016/j.ejca.2003.10.014
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发表时间：
2004-03-01
影响因子：
8.4
通讯作者：
Roukema, JA
中科院分区：
文献类型：
--
作者：
Ernst, MF;Voogd, AC;Roukema, JA
本研究的目的是比较1985-1992年和1993-1999年保乳手术和乳房切除术后局部区域复发率。第一个时期反映了早期的乳房保护经验。第二个时期是对50-69岁的妇女实行乳房X光检查计划的年份。我们收集了1212例患者的1264例可切除乳腺癌（即I、IIA、IIB和IIIA期）的数据，其中385例通过保乳手术切除，879例通过乳房切除术切除。在随访期间，47局部区域复发后，保乳，67后乳房切除术。乳房切除术后5年和10年局部区域复发率分别为5.7%（95%置信区间（CI）4.0-7.4）和11.0%（95% CI 8.0-14.0），保乳术后分别为7.3%（95% CI 4.5-10.1）和15.8%（95% CI 11.2-20.4）。保乳术后8年局部复发率从1985-1992年的20.1%（95%CI 14.7-26.5）降至1993-1999年的5.4%（95%CI 1.8-9.0）（P=0.0018）。尽管接受乳房切除术的患者的分期分布更有利，但在后期未观察到LRR风险显著降低（P=0.18）。病人选择和治疗技术的改进是我们教学医院保乳术后LRR率下降的最可能解释。(C)2003爱思唯尔有限公司。保留所有权利。
The aim of our study was to compare the loco-regional recurrence (LRR) rates after breast-con serving surgery and mastectomy between the time periods of 1985-1992 and 1993-1999. The first period reflects the early experiences with breast conservation. The second period covers the years when a mammographical screening programme was introduced for women 50-69 years of age. We collected data on 1212 patients with 1264 resectable breast cancers (i.e. stage I, IIA, IIB and IIIA), of which 385 were removed by breast conserving surgery and 879 by mastectomy. During follow-up, 47 loco-regional recurrences developed after breast conservation, and 67 after mastectomy. The 5- and 10-year loco-regional recurrence rates were 5.7% (95% Confidence Interval (CI) 4.0-7.4) and 11.0% (95% CI 8.0-14.0), respectively, after mastectomy and 7.3% (95% CI 4.5-10.1) and 15.8% (95% CI 11.2-20.4), respectively, after breast conservation. The 8-year loco-regional recurrence rate after breast conservation decreased from 20.1% (95% CI 14.7-26.5) in the period of 1985-1992 to 5.4% (95% CI 1.8-9.0) in the period of 1993-1999 (P=0.0018). Despite the more favourable stage distribution of the patients undergoing mastectomy, no significant decrease was observed in the LRR risk in the latter period (P=0.18). Improvements in patient selection and treatment techniques are the most likely explanations of the decreasing LRR rate after breast conservation in our teaching hospital. (C) 2003 Elsevier Ltd. All rights reserved.