101例乳腺癌术后胸壁复发的临床分析

目的探讨乳腺癌术后胸壁复发的临床病理特点、治疗方法及预后因素。方法自1995年1月~2001年1月，我院收治了101例乳腺癌术后单纯胸壁复发的患者，对这些患者的临床特点、治疗方式、生存期及预后因素进行了单因素和多因素的分析。随访时间均在5年以上。结果胸壁复发后生存期3~150月，中位生存53月；5年生存率46.5 % (47/101)。单因素分析显示，胸壁复发治疗后肿瘤残留是最强的预后因素；其他因素还包括原发肿瘤的大小、淋巴结状况、分期、术后放疗、原发肿瘤至胸壁复发的时间>20月及复发后的治疗方式(手术及放疗)。多因素分析结果，原发肿瘤>5cm和原发肿瘤至胸壁复发的时间<20月是胸壁复发后生存期的独立预后因素。结论乳腺癌术后胸壁复发的预后相对较好，综合治疗可能有助于提高治愈率。

Isolated Chest Wall Recurrence after Mastectomy: Clinical Analysis of 101 Cases

Objective To investigate the clinical characteristics, treatment methods and prognosis of chest wall recurrence(CWR) after mastectomy. Methods From 1995 to 2001, 101 patients with identified CWRs were observed at our hospital. Clinicopathologic factors were studied by univariate and multivariate analyses for survival after CWR. The median post CWR follow up time was more than 5 years. Results The median survival time after CWR was 53 months (ranging from 3 to 150 months), and the 5 year survival rate was 46.5 % (47/101). The residual recurrence after treatment of CWR was the best outcome predictor based on our univariate analysis. Other significant factors included the characteristics of the initial tumor (size, nodal status, and stage), radiation after mastectomy, time to CWR more than 20 months, and treatment methods for CWR (surgery or radiation). Multivariate analysis showed that the size of primary tumor<5 cm and time to CWR more than 20 months were also independent predictors. Conclusion CWR after mastectomy has a relatively good prognosis. The multi treatment method may improve the survival after CWR.