Department of Surgery, St Vincents University Hospital, Dublin, Ireland.
Department of Surgery, St Vincents University Hospital, Dublin, Ireland.
Clin Breast Cancer. 2021 Aug;21(4):e377-e387. doi: 10.1016/j.clbc.2020.12.005. Epub 2020 Dec 17.
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.
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。
