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肿瘤整形保乳手术后的生活质量:一项系统综述

Quality of life after oncoplastic breast-conserving surgery: a systematic review.

作者信息

Aristokleous Iliana, Saddiq Muhammad

机构信息

Department of Surgery, Enköpings Hospital, Enköping, Uppsala County, Sweden.

School of Health and Related Research, The University of Sheffield, Sheffield, UK.

出版信息

ANZ J Surg. 2019 Jun;89(6):639-646. doi: 10.1111/ans.15097. Epub 2019 Apr 12.

Abstract

BACKGROUND

Oncoplastic breast-conserving surgery (OBCS) has gained increasing attention as a treatment option for early breast cancer patients, aiming to achieve the best possible breast symmetry with concomitant oncological safety. This paper aims to systematically review the current literature on patient quality of life (QoL) after OBCS compared with QoL after breast-conserving surgery (BCS) alone.

METHODS

MEDLINE via Ovid, CINAHL via EBSCO and PsycINFO via OvidSP were searched to retrieve all relevant studies. The reference lists of identified eligible studies were manually examined to search for additional eligible studies. The methodological quality of the included studies was assessed using the Critical Appraisal Skills Programme.

RESULTS

A total of six articles met the inclusion criteria. Most of the studies used validated patient-reported outcome measures for assessing QoL with good response rates. However, only one study was of sufficiently good quality to provide good evidence (P < 0.05) in favour of OBCS, while the remainder were of low to moderate quality with differences in outcomes that were not statistically significant.

CONCLUSION

The review found that the current evidence base is limited and not adequate enough to support or to reject the assumption that OBCS is associated with improved QoL when compared with QoL post-BCS. However, the majority of studies show that OBCS is associated with a trend towards better patient QoL. The impact of OBCS on patient QoL needs to be more adequately investigated. Large prospective cohort studies to assess the impact of OBCS on QoL compared with QoL post-BCS are strongly recommended.

摘要

背景

肿瘤整形保乳手术(OBCS)作为早期乳腺癌患者的一种治疗选择,越来越受到关注,其目的是在保证肿瘤学安全性的同时实现尽可能好的乳房对称性。本文旨在系统回顾当前关于OBCS术后患者生活质量(QoL)与单纯保乳手术(BCS)术后QoL比较的文献。

方法

通过Ovid检索MEDLINE、通过EBSCO检索CINAHL以及通过OvidSP检索PsycINFO,以检索所有相关研究。对已识别的合格研究的参考文献列表进行人工检查,以寻找其他合格研究。使用批判性评估技能计划评估纳入研究的方法学质量。

结果

共有六篇文章符合纳入标准。大多数研究使用经过验证的患者报告结局指标来评估QoL,且应答率良好。然而,只有一项研究质量足够高,能够提供有力证据(P < 0.05)支持OBCS,其余研究质量低至中等,结果差异无统计学意义。

结论

该综述发现,目前的证据基础有限,不足以支持或反驳与BCS术后QoL相比,OBCS与改善的QoL相关这一假设。然而,大多数研究表明,OBCS与患者QoL改善的趋势相关。OBCS对患者QoL的影响需要更充分地研究。强烈建议进行大型前瞻性队列研究,以评估与BCS术后QoL相比,OBCS对QoL的影响。

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