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[新辅助全身治疗在原发性乳腺癌治疗中的术后并发症——病例对照研究]

[Post operative complications after neoadjuvant systemic therapy in primary breast cancer treatment - Case-control study].

作者信息

Marszalek D, Noël J C, Simon P

机构信息

Hôpital Erasme, Service de Gynécologie-Obstétrique, ULB, Route de Lennik 808, Anderlecht, Belgium.

出版信息

Rev Med Brux. 2016;37(6):469-475.

PMID:28525174
Abstract

The use of neoadjuvant systemic therapy (NST) for the primary breast cancer treatment has constantly increased. Initially used to improve breast-conserving surgery (BCS) rate as well as for patients with inflammatory or inoperable locally advanced breast cancer, today, NST is used as a test of chemosensitivity and predictive factor by assessing pathologic complete response. With the increasing use of NST, it is fundamental to establish if NST increases postoperative morbidity.. In our study, the postoperative complications associated with NST were examined. We analyzed the data obtained from patients undergoing treatment for breast cancer in a University Hospital between 2003-2014 in a case-control study. We selected 286 patients attributed to two groups according to the surgery type: Group A, 150 patients undergoing breast conserving surgery with axillary node dissection (75 cases after NST and 75 controls with surgery alone) and group B, 136 patients undergoing mastectomy with axillary node dissection (68 cases after NST and 68 controls). There was no statistically significant difference between both groups in post-operative recovery or the rates of complications: use of antibiotics, re-operation, hematoma, blood transfusion, healing problems, wound infection, lymphocele and lymphoedema. Our study supports the safety of NST and suggests that it is not associated with increased morbidity in the patients undergoing breast surgery as BSC or mastectomy with axillary node dissection.

摘要

新辅助全身治疗(NST)在原发性乳腺癌治疗中的应用一直在增加。NST最初用于提高保乳手术(BCS)率以及治疗炎性或无法手术的局部晚期乳腺癌患者,如今,通过评估病理完全缓解,NST被用作化疗敏感性测试和预测因素。随着NST使用的增加,确定NST是否会增加术后发病率至关重要。在我们的研究中,对与NST相关的术后并发症进行了检查。我们在一项病例对照研究中分析了2003年至2014年期间在一家大学医院接受乳腺癌治疗的患者的数据。根据手术类型将286例患者分为两组:A组,150例行保乳手术加腋窝淋巴结清扫术的患者(75例接受NST后手术,75例仅接受手术作为对照);B组,136例行乳房切除术加腋窝淋巴结清扫术的患者(68例接受NST后手术,68例作为对照)。两组在术后恢复或并发症发生率方面无统计学显著差异,并发症包括抗生素使用、再次手术、血肿、输血、愈合问题、伤口感染、淋巴囊肿和淋巴水肿。我们的研究支持NST的安全性,并表明它与接受BCS或乳房切除术加腋窝淋巴结清扫术的乳腺癌手术患者的发病率增加无关。

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