乳房保护手术还是乳房切除术? : 对生存率的影响
Peer Christiansen1, Marco Mele2, Anne Bodilsen3
1From the Department of Plastic and Breast Surgery, Aarhus University Hospital, Aarhus, Denmark.
概括
与早期乳腺癌的乳腺切除术相比,乳腺保护手术 (BCS) 显示出更好的生存率. 这项对最近研究的元分析证实,BCS在可行的情况下是潜在的优越治疗选择.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 流行病学 流行病学
背景情况:
- 早期的试验发现,乳房保护手术 (BCS) 和乳房切除术之间没有生存差异.
- 最近的基于人群的研究表明,使用BCS可以改善长期存活率.
研究的目的:
- 系统地审查和分析最近基于人群的BCS与乳腺切除术生存结果的观察性研究.
- 评估目前关于BCS和乳腺切除术相对有效性的证据.
主要方法:
- 在PubMed,Embase和Cochrane数据库中的系统文献搜索.
- 使用随机效应模型对总生存率 (OS) 和乳腺癌特定生存率 (BCSS) 的危险比率 (HRs) 的元分析.
- 包括30份报告,其中25项研究为元分析做出了贡献.
主要成果:
- 与乳房切除术相比,BCS与显著更好的OS (HR=1.34) 和BCSS (HR=1.38) 相关.
- 根据淋巴结状况,年龄和放射治疗的亚组分析证实,使用BCS改善了OS.
- 通过调整的预后变量的数量或类型,生存差异没有显著的缓解.
结论:
- 目前来自大规模人口研究的证据表明,BCS对乳腺切除术的生存益处高于乳腺切除术.
- 应考虑BCS作为早期乳腺癌 (T1-2N0-1M0) 推的治疗方法,当可以实现激进乳腺切除术时.
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