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目的:评价不同术式对乳腺癌术后生活质量(QOL)的影响和安全性。方法:纳入98例保乳术、84例改良根治术和65例经典根治术患者,用中文版乳腺癌治疗功能评价(FACT-B)量表测评术后1年的QOL,追踪随访5年,以局部复发、远处转移和死亡为终点事件。结果:(1)3组患者总体QOL存在显著差异,保乳组和改良根治组在生理状况、社会/家庭状况、情感状况、功能状况、附加关注5个领域的评分均高于经典根治组;与改良根治组相比,保乳组附加关注评分较高。(2)保乳组、改良根治组和经典根治组的5年所有终点事件发生率分别是21.4%、23.8%和18.5%,Log Rank(Mantel-Cox)χ2=0.538,P=0.764。结论:接受保乳术、改良根治术者的生存率与经典根治术者等同,但其术后生存质量优于经典根治术者。
Objective: To evaluate the effect and safety of different surgical procedures on postoperative quality of life (QOL) of breast cancer. Methods: A total of 98 cases of conservative surgery, 84 modified radical mastectomy and 65 cases of classic radical mastectomy were enrolled in this study. The QOL of 1 year after the operation was evaluated by the FACT-B Chinese version, followed up for 5 years, To local recurrence, distant metastasis and death as the end point. Results: (1) There were significant differences in total QOL among the three groups. The score of nursing group and modified radical group in five areas of physiological status, social / family status, emotional status, functional status and additional attention were higher than that of classic radical group. Compared with the modified radical treatment group, nursing group additional attention score higher. (2) The 5-year incidences of all end-points in the breast conserving group, modified radical group and classical radical group were 21.4%, 23.8% and 18.5% respectively, and Log Rank (Mantel-Cox) χ2 = 0.538, P = 0.764. Conclusion: The survival rate of conservative surgery and modified radical mastectomy is the same as that of classic radical mastectomy, but the postoperative quality of life is better than that of classical radical mastectomy.