中国和加拿大两所医院乳腺癌病人术后生存分析比较

目的 :探讨我国北方地区乳腺癌病人的 5年生存率、主要预后因素及其与加拿大类似气候地区的异同。方法 :收集吉林大学第一医院 (中国长春 ,简称 FTH)和拉瓦尔大学圣萨可门医院 (加拿大魁北克 ,简称 SSH) 10 0 2例乳腺癌病人的资料 ,包括自然状况及预后因素 (经历史性队列研究 ) ,采用Kaplan- Meier方法计算生存指标 ,并进行分层比较。结果 :病人的平均年龄 FTH较 SSH小 10岁( P<0 .0 0 0 1) ;病人原发肿瘤大小差异有显著性 ( P=0 .0 36) ;腋窝淋巴结有转移病人的比例 FTH明显地高于 SSH( P<0 .0 0 0 1) ;手术方式 FTH多为乳腺癌改良根治术 ,SSH则对 、 期病人首选局部切除 ;病人术后 5年生存率 :FTH为 74 .2 % ,SSH为 76.3% ,差异不显著 ( P=0 .30 2 )。结论 :尽管两所医院病人的就诊年龄、肿瘤大小、淋巴结转移个数有不同 ,但其 5年生存率却无显著性差异。

Comparison of survival among patients with breast cancer treate d at First Teaching Hospital,Changchun,China and at Saint-Sacrement Hospital,Q uebec,Canada

Objective:To explore th five year survivals and some prognostic factors for bres at cancer patients in the north areas of China,and the indentification or differ e nces on these variables among breast cancer patients between in China and in Can ada.Methods:All Data were collected from the hospital records of 1 002 breast cancer patients who were initially treated at the First Hospital of Jilin Uni versity (116 cases FTH,Changchun China) and the Sain t-Sacrement Hospital (886 cases in SSH,Quebec Canada) respectively by use of Historical Cohort survey,and the survival propotions were calculated and comp ared stradly by use of Kaplan-Meier method.Results:Age at diagnosis was substantially lower (average of age about 10 years less) among breast cancer patients seen at FTH compared to those treated at SSH (P<0.0001).Patients in the two hospitals differed in respect to tumor size at pathology (P=0.036).The proportion of women with lymph node involvement was greater at FTH (61.1%) than that at HSS(37.3%)(P<0.0001).Surgical treat ment of breats cancer was varied considerably:the radical mastectomy was frequen tly performed for andy stage of breast cancer patients in Changchun,but the part ial mastectomy was mainly used for patients with stage Ⅰ or Ⅱ in Quebec.The fi ve year survival was 74.2% among breast cacer patients seen at FTH compared to 7 6.3% among women treated at HSS,and there was no singnificant differrence (P =0.302). Conclusion:Five year survival of breast cancer patients treated surgically in C hangchun,China,was similar to that of patients treated surgically in Quebec,Can ada except for differences in age at diagnosis,tumor size and lymph node involve ment