摘要
目的了解我国保乳手术的开展现状,探讨其在乳腺癌外科术式中所占规模的影响因素。方法在全国范围内,选择具有代表性的110家2017年乳腺癌手术量超过200例的医疗机构进行保乳手术开展情况的问卷调研。结果中国乳腺癌的保乳总体比例为21.9%。不同人均国内生产总值(gross domestic product,GDP)的地区保乳比例不同,平均保乳比例随人均GDP(P=0.001)和年手术量的升高(P=0.042)而增加。按照肿瘤分期进行亚组分析,I期乳腺癌患者中保乳占乳腺癌手术比例最高,且教学医院高于非教学医院(P=0.021)。保乳手术后切缘阳性再手术占总保乳手术比例少,且肿瘤专科医院低于综合医院(P=0.023)。保乳手术切缘取材与病理评估方法与医院所在地人均GDP和医院类别无关(均P>0.05)。结论我国保乳手术比例有所增加,但仍远低于国外水平。
Objective To determine national trends for breast conserving surgery and to explore the factors affecting the scale of breast conserving surgery in China.Methods A questionnaire survey was mailed to 110 hospitals with an year's volume of more than 200 breast cancer surgeries in each center in China concerning hospital variations and percentage of breast conserving surgery.Results The overall proportion of breast conserving surgery is 21.9%for operable breast cancer in China.There is a significant positive correlation between local Gross Domestic Product(GDP)and the rate of breast conserving surgery(P=0.001).Hospitals with higher annual operation volume have higher breast-conserving ratios(P=0.042).Compared with non-teaching hospitals,more patients with stage I breast cancer underwent breast conserving surgery in teaching hospitals(P=0.021).After breast-conserving surgery,the proportion of positive margins needing reoperation had a lower percentage and in cancer hospitals it was the lowest(P=0.023).The method of pathological evaluation and the remedy strategy for positive margin was not related to per capita GDP and hospital category(P>0.05).Conclusions This survey demonstrates the current practices of breast conserving surgery in China.Local GDP,hospital category and tumor stage were factors influencing breast conserving surgery.Breast conserving surgery in China is still at a low level compared with developed countries.
作者
郑舒月
苏永辉
郭瑢
修秉虬
王嘉
张琪
季玮儒
李伦
杨犇龙
张莹莹
邵志敏
吴炅
Zheng Shuyue;Su Yonghui;Guo Rong;Xiu Bingqiu;Wang Jia;Zhang Qi;Ji Weiru;Li Lun;Yang Benlong;Zhang Yingying;Shao Zhimin;Wu Jiong(Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Breast Surgery,Fudan University Shanghai Cancer Center,Shanghai 200032,China;Collaborative Innovation Center far Cancer Medicine,Guangzhou 510275,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2020年第4期314-318,共5页
Chinese Journal of General Surgery
基金
国家重点研发计划(2017YFC1311004)。
关键词
乳腺肿瘤
横断面研究
保乳手术
Breast neoplasms
Cross sectional studies
Breast conserving surgery
作者简介
通信作者:吴炅,Email:wujiong1122@vip.sina.com,电话:021-64175590-88607。
