Physical and psychological morbidity after axillary lymph node dissection for breast cancer
Physical and psychological morbidity after axillary lymph node dissection for breast cancer
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DOI：
10.1200/jco.1999.17.1.143
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发表时间：
1999-01-01
影响因子：
45.3
通讯作者：
Goss, P
中科院分区：
文献类型：
--
作者：
Hack, TF;Cohen, L;Goss, P
目的：腋窝淋巴结清扫术（ALND）的替代方案正在开发中，围绕着这种常规手术的治疗效益和整体效用的争议。虽然已知与ALND相关的潜在负面副作用，但我们开始研究这些副作用是否对患者报告的生活质量和心理健康有重大影响。患者和方法：我们调查了222名接受ALND作为乳腺癌手术一部分的妇女。所有女性接受了手臂/肩部活动范围的物理治疗评估，并完成了修改后的术后疼痛问卷、疼痛残疾指数、McGill疼痛问卷（简短形式）、欧洲癌症研究和治疗组织生活质量问卷和心理健康问卷。72%的女性在采访前一周经历过手臂/肩膀疼痛、无力或麻木，73%的女性受影响的手臂/肩膀的活动范围受损。据报道，疼痛的严重程度为低至中度，年轻患者比老年患者经历更大的疼痛。疼痛严重程度与淋巴结切除数量和接受化疗呈正相关，与手术后的时间或接受放疗的时间无显著相关。据报道，癌症特异性生活质量和心理健康水平普遍较高，McGill疼痛问卷显著预测生活质量，疼痛残疾指数和物理治疗评估显著预测心理健康。结论：对于大多数乳腺癌女性，ALND术后的手术相关症状持续存在，且与手术后或接受放射治疗的时间无显著相关性。这些症状和相关残疾可显著预测癌症特异性生活质量和心理健康。[J]中国临床肿瘤杂志（英文版）：2003。
Purpose: Alternatives to axillary lymph node dissection (ALND) are being developed amid controversy surrounding the therapeutic benefit and overall utility of this routine surgical procedure. Although potential negative side effects associated with ALND are known, we set out to examine whether these side effects contribute significantly to patient reports of quality of life and mental health.Patients and Methods: We surveyed 222 women who had received an ALND as part of breast cancer surgery. All women underwent a physical therapy assessment of range of arm/shoulder motion and completed the Modified Post-operative Pain Questionnaire, the Pain Disability Index, the McGill Pain Questionnaire (short form), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and the Mental Health Inventory,Results: Seventy-two percent of the women experienced arm/shoulder pain, weakness, or numbness in the week before the interview, and range of motion of the affected arm/shoulder was impaired in 73% of the women. Severity of pain was reported to be low to moderate, and younger patients experienced greater pain than older patients. Pain severity correlated positively with the number of lymph nodes removed and receipt of chemotherapy and was not significantly related to length of time since surgery or receipt of radiation therapy. Generally high levels of cancer-specific quality of life and mental health were reported, Quality of life was significantly predicted by the McGill Pain Questionnaire, and mental health was significantly predicted by the Pain Disability Index and the physical therapy assessment.Conclusion: Surgery-related symptoms after ALND persist for a majority of women with breast cancer and are not significantly related to time since surgery or receipt of radiation therapy These symptoms and associated disability are significantly predictive of cancer-specific quality of life and mental health.J Clin Oncol 17:143-149, (C) 1999 by American Society of Clinical Oncology.