实用临床医药杂志2025，Vol.29Issue(15)：35-39,46,6.DOI:10.7619/jcmp.20250433
乳腺癌新辅助化疗后前哨淋巴结阴性患者豁免腋窝淋巴结清扫术的预后分析
Prognostic analysis of patients with negative sentinel lymph node after neoadjuvant chemotherapy for breast cancer exempt axillary lymph node dissection
摘要
Abstract
Objective To investigate the prognosis of patients with negative sentinel lymph nodes(SLN)after neoadjuvant chemotherapy(NAC)for breast cancer who are exempt from axillary lymph node dissection(ALND)and evaluate its safety in clinical treatment.Methods Clinical data of 2,163 patients initially diagnosed with breast cancer and having negative SLNs after NAC were se-lected from the SEER database from 2018 to 2021.Among them,373 patients underwent only SLN biopsy(SLNB group),and 1,790 patients underwent ALND(ALND group).Propensity score matching(PSM)was used to control for confounding factors,and the Kaplan-Meier method was em-ployed to analyze the overall survival rate.Univariate and multivariate Cox regression analyses were conducted to identify prognostic factors influencing the exemption from ALND in patients with negative SLNs after NAC for breast cancer.Results Before PSM,significant differences were observed be-tween the two groups in terms of clinical tumor stage,molecular subtype,estrogen receptor(ER)sta-tus,progesterone receptor(PR)status,human epidermal growth factor receptor 2(HER-2)status,efficacy of NAC,and breast surgery method(P＜0.05).After PSM,363 patients were included in each group.Univariate Cox regression analysis after PSM revealed that age,clinical tumor stage,and ER status were associated with overall survival(OS)of patients(P＜0.05).There was no sig-nificant difference in OS between patients who underwent SLNB and those who underwent ALND(P＞0.05).Multivariate Cox regression analysis indicated that age and clinical tumor stage were independent factors influencing OS in patients with negative SLNs after NAC.Survival curve analysis after PSM showed no statistically significant difference in overall survival rate between the SLNB and ALND groups(P=0.278).Conclusion Exemption from ALND in patients with negative SLNs af-ter NAC is feasible and does not affect the overall survival rate of patients.关键词
乳腺癌/新辅助化疗/前哨淋巴结/腋窝淋巴结清扫/预后/倾向评分匹配/总生存率/生存曲线分析Key words
breast cancer/neoadjuvant chemotherapy/sentinel lymph node/axillary lymph node dissection/prognosis/propensity score matching/overall survival rate/survival curve analysis分类
医药卫生引用本文复制引用
肖顺崇,覃俊仕,张艳珍,吴瑞正,吴志懂,滕奔宇,张志远,李青雲,农雯雄..乳腺癌新辅助化疗后前哨淋巴结阴性患者豁免腋窝淋巴结清扫术的预后分析[J].实用临床医药杂志,2025,29(15):35-39,46,6.基金项目
贵港市自筹经费科研项目(贵科攻2100030) （贵科攻2100030）
