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中国癌症防治杂志

中国癌症防治杂志

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保乳手术和改良根治术治疗老年乳腺癌的系统评价

黄琴滔;卢榜裕;黄建康;黄飞;靳小建;黄玉斌;   

  1. 广西医科大学研究生学院;广西医科大学第一临床医学院微创外科中心;
  • 收稿日期:2010-06-25 修回日期:2010-06-25 出版日期:2010-06-25 发布日期:2010-06-25

Breast conservative surgery versus modified radical mastectomy for elderly patients with breast cancer:a systematic review

HUANG Qin-tao1,LU Bang-yu2,HUANG Jian-kang1,et al.   

  1. (1Graduate School of Guangxi Medical University,2Department of Minimally Invasive Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China
  • Received:2010-06-25 Revised:2010-06-25 Online:2010-06-25 Published:2010-06-25

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被引次数

23

摘要： 目的评价保乳手术与改良根治术治疗老年乳腺癌的疗效。方法通过计算机检索Cochrane Library(2009年1期)、MEDLINE(PubMed1965~2009.5.2)、Embase(1974~2009.5.2)、CBM(1978~2009.5.2)和CNKI(1979~2009.5.2)等有关保乳手术与改良根治术治疗老年乳腺癌的临床对照研究资料,对纳入的文献进行资料提取和质量评价,采用RevMan5.0软件进行统计学分析。结果共纳入2个研究,一个是随机对照试验,另一个是半随机对照试验,共343例患者。保乳手术与改良根治术在5年生存率、死亡率、局部复发率和远处转移率等方面比较,差异均无统计学意义。10年死亡率和远处转移率保乳手术比改良根治术显著降低,差异有统计学意义,而在10年生存率、局部复发率和无瘤生存率方面,保乳手术与改良根治术差异无统计学意义。结论对分期为T1、T2、T3a和N0、N1a、N1b、M0并能耐受保乳手术和改良根治术两种术式的单发乳腺癌老年女性患者,保乳手术是较改良根治术更好的选择。目前比较保乳手术和改良根治术治疗老年乳腺癌的研究尚缺乏,有必要开展和设计更多、高质量的随机对照试验。

关键词: 乳腺癌, 保乳手术, 改良根治术, 老年人, 系统评价

Abstract: Objective To review the efficacy of breast conservative surgery(BCS),compared with modified radical mastectomy(MRM)for elderly patients with breast cancer.MethodsLiteratures related to clinical trials of comparing BCS and MRM on elderly patients with breast cancer were searched from Cochrane Library(Issue 1,2009),MEDLINE(PubMed 1965～2009.5.2),Embase(1974～2009.5.2),CBM-disc(1978～2009.5.2)and CNKI(1979～2009.5.2).The qualities of the literatures were assessed before data collection,and the statistic analysis was conducted by using RevMan 5.0.ResultsTwo studies were enrolled which included a randomized controlled trial(RCT)and a quasi-RCT,and involved totally 343 patients.No significant differences were found between BCS and MRM in terms of survival rate,mortality,local relapse rate and distant metastasis rate at 5-year.While at 10-year,the BCS group was with significantly lower mortality and distant metastasis rate,but two groups were with similar survival rate,local relapse rate and disease free survival rate.ConclusionsWhen elderly patients with solitary breast cancer staged at T1,T2 or T3a and N0,N1a,N1b or M0 are able to tolerate both BCS and MRM,BCS should be a superior option.Since the comparison study on BCS and MRM is limited currently,it is necessary to develop and design more high quality randomized controlled trials.

Key words: Breast conservative surgery, Modified radical mastectomy, Elderly, Breast cancer, Systematic review