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术后伤口并发症对乳腺癌即刻乳房重建后肿瘤学结局的影响:一项荟萃分析。

The Impact of Postoperative Wound Complications on Oncological Outcomes Following Immediate Breast Reconstruction for Breast Cancer: A Meta-analysis.

机构信息

Department of Surgery, St Vincents University Hospital, Dublin, Ireland.

Department of Surgery, St Vincents University Hospital, Dublin, Ireland.

出版信息

Clin Breast Cancer. 2021 Aug;21(4):e377-e387. doi: 10.1016/j.clbc.2020.12.005. Epub 2020 Dec 17.

Abstract

The association between immediate breast reconstruction (IBR)-related wound complications and breast cancer recurrence (BCR) remains uncertain. This study aimed to investigate the oncological outcomes in patients with wound complications following mastectomy and IBR. A comprehensive search was undertaken for all studies describing complications in patients with breast cancer following IBR. Studies were included if they reported on complications and investigated their relationship with BCR. A meta-analysis was performed using a random-effects model, with data presented as odds ratios and 95% confidence intervals. A total of 1418 patients from five studies were included in the final analysis. The mean age of patients included was 47.2 years. A total of 382 (26.9%) patients had postoperative complications following a majority of implant-based IBR (929/1418). A total of 158 (11.1%) recurrences, which included 63 locoregional and 106 distant recurrences, was noted at a mean follow-up of 66 months. Although there was an increase in recurrence rates in the complication group (n = 66/382; 17.3% vs. n = 92/1036; 8.9%), there was no significant association between complications and BCR (17.3% vs. 8.9%; P = .18) or mortality (3.6% vs. 2.3%; P = .15). Time to adjuvant therapy was significantly increased in patients with complications (mean difference, 8.69 days; range, 1.18-16.21 days; P = .02; I = 0.02). This meta-analysis demonstrated a higher incidence of wound complications following IBR and a statistically significant increased time to adjuvant therapy. However, this did not translate into adverse oncological outcomes in patients with breast cancer undergoing IBR.

摘要

乳房重建相关的伤口并发症与乳腺癌复发(BCR)之间的关联仍不确定。本研究旨在探讨接受乳房切除术和乳房即刻重建(IBR)后发生伤口并发症患者的肿瘤学结局。对所有描述 IBR 后乳腺癌患者并发症的研究进行了全面检索。如果研究报告了并发症,并调查了其与 BCR 的关系,则纳入研究。使用随机效应模型进行荟萃分析,数据以比值比和 95%置信区间表示。最终分析纳入了来自 5 项研究的 1418 例患者。纳入患者的平均年龄为 47.2 岁。大多数采用植入物为基础的 IBR 后(929/1418)有 382 例(26.9%)患者出现术后并发症。在平均 66 个月的随访中,共观察到 158 例(11.1%)复发,包括 63 例局部区域复发和 106 例远处复发。虽然并发症组的复发率有所增加(66/382,17.3% vs. 92/1036,8.9%),但并发症与 BCR(17.3% vs. 8.9%;P=0.18)或死亡率(3.6% vs. 2.3%;P=0.15)之间无显著关联。并发症患者的辅助治疗时间明显延长(平均差异,8.69 天;范围,1.18-16.21 天;P=0.02;I=0.02)。这项荟萃分析表明,IBR 后伤口并发症的发生率较高,辅助治疗时间明显延长,但这并未转化为接受 IBR 的乳腺癌患者的不良肿瘤学结局。

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