对乳腺癌患者进行乳腔镜与传统腋窝淋巴结清扫的比较：来自一项随机多中心试验的长期结果

Fuxing Hospital, Capital Medical University, A20, Fuxingmenwai St, Xicheng District, Beijing, 100038, China

Objective: To compare the long-term results of mastoscopic axillary lymph node dissection (MALND) and conventional axillary lymph node dissection (CALND). Patients and Methods: From January 1, 2003, through December 31, 2005, a group of 1027 consecutive patients with operable breast cancer were randomly assigned to 1 of 2 study groups: MALND and CALND. The median follow-up was 63 months. The primary end points of the study were operative outcomes, complication reduction, function conservation, and cosmetics. The secondary end points were disease-free and overall survival. Results: The mean operative blood loss in the MALND group was less than in the CALND group (P<.001). The patients who underwent MALND had less axillary pain, numbness or paresthesias, and arm swelling (P<.001). The aesthetic appearance of the axilla in the MALND group was much better than that in the CALND group (P=.001 at 6 months and P=.002 at 24 months). A significant difference was found between the 2 groups in distant metastasis (P=.04). The disease-free survival rate was 64.5% in the MALND group and 60.8% in the CALND group (P=.88). The overall survival rate was 81.7% in the MALND group and 78.6% in the CALND group (P=.95). Conclusion: Compared with CALND, MALND has advantages in operative outcomes, complication reduction, function conservation, and cosmetics. © 2012 Mayo Foundation for Medical Education and Research.

Luo, C.; Fuxing Hospital, Capital Medical University, A20, Fuxingmenwai St, Xicheng District, Beijing, 100038, China; email:luochengyu@163.com