马林晓曦, 黄乃思. Relationship between breast reconstruction and travel distance[J]. China Oncology, 2018, 28(2): 140-145. DOI: 10.19401/j.cnki.1007-3639.2018.02.010.
背景与目的:乳腺癌手术方式的选择受到诸多因素影响,本研究旨在分析乳腺癌患者选择乳房重建手术的影响因素,重点探讨居住地距离与乳房重建的关系。方法:回顾性分析了1999年1月—2015年12月复旦大学附属肿瘤医院收治的因单侧或双侧0~Ⅱ期乳腺癌行全乳切除术的女性患者临床资料,分析居住地距离与乳房重建比例的关系。结果:非上海患者选择全乳切除术后乳房重建比例高于上海患者(6.1% vs 4.5%,P0.001)。居住地距离影响乳房重建比例(P=0.035)。单因素分析显示,居住地距离越远,选择乳房重建手术比例越高,而年龄、体质量指数(body mass index,BMI)、TNM分期与乳房重建的选择呈负相关(P均0.001)。多因素分析显示,年龄增长、BMI增加、TNM分期较晚是拒绝行乳房重建的独立影响因素(P均0.001),而居住地距离不是乳房重建的独立影响因素(P0.05),且与具体乳房重建方式无交互作用。年龄与居住地距离呈负相关(P0.001)。结论:乳腺癌患者的居住地距离与乳房重建比例呈线性相关;年龄、BMI和疾病分期是影响乳房重建的主要因素。
Abstract
Background and purpose: Many factors have impacts on the surgery approach of breast cancer. The purpose of this study was to analyze the influence factors of breast reconstruction for patients with breast cancer
focusing on the relationship between travel distance and breast reconstruction. Methods: Retrospective review of all female breast cancer patients staging 0-Ⅱ who underwent unilateral or bilateral mastectomy with or without breast reconstruction at Fudan University Shanghai Cancer Center from 1999 to 2015 was conducted in the study. Analysis of travel distance and breast reconstruction rate was performed. Results: Non-Shanghai patients have higher breast reconstruction rate after mastectomy compared with Shanghai patients (6.1% vs 4.5%
P0.001). Travel distance may have an influence on the breast reconstruction rate (P=0.035). Univariate regression analysis showed that the increase of travel distance was the predictor of breast reconstruction
and that the increase of age or body mass index (BMI)
or the later TNM stage had a negative correlation with breast reconstruction (P0.001). Multiple regression analysis demonstrated that the increase of age or BMI
or the later TNM stage was the independent predictor of the refusal of breast reconstruction (P0.001)
but travel distance was not (P0.05). No significant correlation between the travel distance and breast reconstruction types was indicated. Negative correlation was observed between age and travel distance (P0.001). Conclusion: Age
BMI and tumor stage are the main influence factors of breast reconstruction
while travel distance shows a linear correlation with it.