Departments of Plastic Surgery, Seoul, South Korea.
Departments of Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Br J Surg. 2020 Aug;107(9):1154-1162. doi: 10.1002/bjs.11572. Epub 2020 Apr 4.
Immediate breast reconstruction is safe from an oncological perspective, but the relatively high rate of postoperative complications raises oncological concerns. The present study aimed to evaluate the potential influence of postoperative complications after immediate breast reconstruction on breast cancer recurrence and survival.
Patients with breast cancer who had total mastectomy and immediate reconstruction between 2008 and 2013 were followed for at least 5 years. The impact of postoperative complications on oncological outcomes was assessed using multivariable Cox regression analyses.
In total, 438 patients with a median follow-up of 82 months were analysed. Five-year local recurrence-free, disease-free and overall survival rates were 95·4, 93·1 and 98·4 per cent respectively. Postoperative complications developed in the operated breast in 120 patients (27·4 per cent) and at other sites (flap donor) in 30 patients (6·8 per cent). Development of breast complications was associated with significantly increased rate of recurrence compared with no complications (16·7 versus 5·9 per cent; P = 0·002). In multivariable analysis, patients with breast complications had significantly worse disease-free survival than those with no complications (hazard ratio (HR) 2·25; P = 0·015). This remained significant in patients who received adjuvant therapy without delay (8 weeks or less after surgery) (HR 2·45; P = 0·034).
Development of postoperative complications in the breast can have a negative impact on survival and recurrence after immediate reconstruction.
即刻乳房重建从肿瘤学角度来看是安全的，但较高的术后并发症发生率引发了肿瘤学方面的担忧。本研究旨在评估即刻乳房重建后术后并发症对乳腺癌复发和生存的潜在影响。
对 2008 年至 2013 年间接受全乳切除术和即刻重建的乳腺癌患者进行了至少 5 年的随访。使用多变量 Cox 回归分析评估术后并发症对肿瘤学结局的影响。
共分析了 438 例患者，中位随访时间为 82 个月。5 年局部无复发生存率、无病生存率和总生存率分别为 95.4%、93.1%和 98.4%。120 例（27.4%）患者在手术乳房中出现术后并发症，30 例（6.8%）患者在其他部位（皮瓣供区）出现术后并发症。与无并发症患者相比，发生乳房并发症患者的复发率显著升高（16.7%比 5.9%；P=0.002）。多变量分析显示，与无并发症患者相比，发生乳房并发症的患者无病生存率显著更差（风险比（HR）2.25；P=0.015）。在未延迟接受辅助治疗（术后 8 周或更短时间内）的患者中，这种情况仍然显著（HR 2.45；P=0.034）。
乳房术后并发症的发生可能对即刻重建后的生存和复发产生负面影响。
