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新辅助化疗后乳腺癌的手术时机影响术后并发症发生率。

Surgical timing following neoadjuvant chemotherapy for breast cancer affects postoperative complication rates.

机构信息

Oregon Health & Science University, Department of Surgery, 3181 SW Sam Jackson Park Rd, Portland, 97239, OR, USA.

Legacy Cancer Institute, Legacy Medical Group Surgical Oncology, 1040 NW 22nd Ave, Suite 560, Portland, 97227, OR, USA.

出版信息

Am J Surg. 2020 May;219(5):741-745. doi: 10.1016/j.amjsurg.2020.02.061. Epub 2020 Mar 10.

Abstract

BACKGROUND

Neoadjuvant chemotherapy (NAC) is increasingly used in the treatment of breast cancer. The time interval from last dose of cytotoxic chemotherapy to surgery (TTS) can vary widely. We aimed to evaluate the effect of TTS on postoperative complications.

METHODS

A retrospective review for women treated with NAC at our institution between January 2011 through December 2016 was performed. Charts were reviewed for postoperative wound complications, and multivariate analysis was performed.

RESULTS

455 patients were identified. Median TTS was 30 days (range 11-228). On multivariate analysis, TTS of less than 28 days was associated with 70% higher odds of any wound complication (p < 0.05). Increasing age had the strongest association with the presence of any wound complication (p < 0.0001). The majority of complications were treated in the outpatient setting (n = 80, 83%).

CONCLUSION

Following NAC for breast cancer, TTS less than 28 days is a risk factor for postoperative wound complications; however, the majority of complications are minor and treated in the outpatient setting. Additional data are needed to determine optimal TTS for oncologic outcomes.

摘要

背景

新辅助化疗(NAC)在乳腺癌治疗中越来越多地被使用。从细胞毒性化疗最后一次剂量到手术的时间间隔(TTS)差异很大。我们旨在评估 TTS 对术后并发症的影响。

方法

对 2011 年 1 月至 2016 年 12 月期间在我院接受 NAC 治疗的女性进行了回顾性研究。对术后伤口并发症进行了图表回顾,并进行了多变量分析。

结果

共确定了 455 例患者。TTS 的中位数为 30 天(范围为 11-228)。多变量分析显示,TTS 小于 28 天与任何伤口并发症的发生几率增加 70%相关(p<0.05)。年龄的增加与任何伤口并发症的发生具有最强的相关性(p<0.0001)。大多数并发症在门诊治疗(n=80,83%)。

结论

在接受乳腺癌 NAC 治疗后,TTS 小于 28 天是术后伤口并发症的危险因素;然而,大多数并发症为轻微且在门诊治疗。需要进一步的数据来确定最佳的 TTS 以获得更好的肿瘤学结果。

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