Zhang P, Li C-Z, Wu C-T, Jiao G-M, Yan F, Zhu H-C, Zhang X-P
College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, Hebei, China.
Department of Oncological Surgery, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, China.
Eur J Surg Oncol. 2017 Feb;43(2):285-293. doi: 10.1016/j.ejso.2016.07.006. Epub 2016 Jul 27.
The purpose of this study was to compare patient outcomes between immediate breast reconstruction (IBR) after mastectomy and mastectomy alone.
We conducted a comprehensive literature search of PUBMED, EMBASE, Web of Science, and Cochrane Library. The primary outcomes evaluated in this review were overall survival, disease-free survival and local recurrence. Secondary outcome was the incidence of surgical site infection. All data were analyzed using Review Manager 5.3.
Thirty-one studies, involving of 139,894 participants were included in this paper. Pooled data demonstrated that women who had IBR after mastectomy were more likely to experience surgical site infection than those treated with mastectomy alone (risk ratios 1.51, 95% CI: 1.22-1.87; p = 0.0001). There were no significant differences in overall survival (hazard ratios 0.92, 95% CI: 0.80-1.06; p = 0.25) and disease-free survival (hazard ratios 0.96, 95% CI: 0.84-1.10; p = 0.54) between IBR after mastectomy and mastectomy alone. No significant difference was found in local recurrence between two groups (risk ratios 0.92, 95% CI: 0.75-1.13; p = 0.41).
Our study demonstrates that IBR after mastectomy does not affect the overall survival and disease-free survival of breast cancer. Besides, no evidence shows that IBR after mastectomy increases the frequency of local recurrence.
本研究的目的是比较乳房切除术后即刻乳房重建(IBR)与单纯乳房切除术患者的预后。
我们对PUBMED、EMBASE、科学网和考克兰图书馆进行了全面的文献检索。本综述评估的主要结局为总生存期、无病生存期和局部复发情况。次要结局为手术部位感染的发生率。所有数据均使用Review Manager 5.3进行分析。
本文纳入了31项研究,涉及139,894名参与者。汇总数据表明,乳房切除术后接受IBR的女性比单纯接受乳房切除术的女性更易发生手术部位感染(风险比1.51,95%置信区间:1.22 - 1.87;p = 0.0001)。乳房切除术后IBR与单纯乳房切除术患者在总生存期(风险比0.92,95%置信区间:0.80 - 1.06;p = 0.25)和无病生存期(风险比0.96,95%置信区间:0.84 - 1.10;p = 0.54)方面无显著差异。两组在局部复发方面未发现显著差异(风险比0.92,95%置信区间:0.75 - 1.13;p = 0.41)。
我们的研究表明,乳房切除术后IBR不影响乳腺癌患者的总生存期和无病生存期。此外,没有证据表明乳房切除术后IBR会增加局部复发的频率。