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肺部是最常见的乳腺癌转移部位之一，但是手术对于乳腺癌患者孤立恶性肺部结节的作用尚不明确。 2017年8月28日，美国乳腺外科医师学会、外科肿瘤学会《外科肿瘤学年鉴》在线发表复旦大学附属肿瘤医院和上海医学院的研究报告，探讨了乳腺癌患者孤立恶性肺部结节的手术结局。 本研究回顾了2007年1月～2014年12月连续1286例复旦大学附属肿瘤医院胸部CT或PET/CT扫描检出肺部结节的乳腺癌患者，其中147例孤立恶性肺部结节接受手术和/或化疗。将患者分为3组：接受手术的原发性肺癌患者、接受手术的肺转移患者、接受化疗的肺转移患者。对所有3组患者进行生存结局分析，包括总生存、无进展生存，并评估肺转移患者无进展生存的预后因素。 结果发现：
因此，手术应被作为乳腺癌患者孤立恶性肺部结节诊断和治疗的有效选择。 Ann Surg Oncol. 2017 Aug 28. [Epub ahead of print] Surgical Outcomes of Isolated Malignant Pulmonary Nodules in Patients with a History of Breast Cancer. Song Z, Ye T, Ma L, Xiang J, Chen H. Department of Thoracic Surgery, Shanghai Cancer Center, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. BACKGROUND: The role of surgery for isolated malignant pulmonary nodules in breast cancer patients remains unclear. METHODS: A total of 1286 consecutive breast cancer patients with pulmonary nodules detected by thoracic computed tomography (CT) or positron emission tomography (PET)/CT scan at Shanghai Cancer Center, Fudan University, were reviewed. Overall, 147 breast cancer patients with isolated malignant pulmonary nodules receiving surgery and/or chemotherapy were enrolled in the study. Patients were classified into three groups: patients with primary lung cancer (PLC) receiving surgery (Group 1), patients with lung metastasis receiving surgery (Group 2), and patients with lung metastasis receiving chemotherapy (Group 3). Survival outcomes, including overall survival (OS) and progression-free survival (PFS), were analyzed for patients in all three groups, and prognostic factors for PFS for patients with pulmonary metastasis were evaluated. RESULTS: Patients with PLC receiving surgery had better survival outcomes, including OS and PFS, than patients with lung metastases who received surgical resection. Breast cancer patients with solitary lung metastasis who received metastasectomy had a significantly better PFS than those who did not; however, no statistically significant difference in OS was observed between the two groups. A multivariate analysis conducted in patients with isolated metastatic breast cancer showed that surgery was an independent factor for better PFS. CONCLUSIONS: Surgery should be considered a valid option for the diagnosis and treatment of breast cancer patients presenting with isolated malignant lung nodules. PMID: 28849376 DOI: 10.1245/s10434-017-6067-0 |
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