Rini Irena Sakura, Gunardi Alberta Jesslyn, Kevin Jonathan, Marsaulina Renate Parlene, Aryandono Teguh, Dachlan Ishandono, Dwiprahasto Iwan
Department of Plastic Surgery, Dharmais Cancer Hospital, West Jakarta, DKI Jakarta, Indonesia.
Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia.
Plast Reconstr Surg Glob Open. 2021 Mar 15;9(3):e3457. doi: 10.1097/GOX.0000000000003457. eCollection 2021 Mar.
Late stage breast cancer presents with malignant wound causing skin infiltration, pain, bleeding, and malodour, which affect quality of life (QoL). Palliative mastectomy aims to eliminate wound symptoms and requires prolonged wound care to improve QoL. This study aimed to prospectively investigate QoL differences in 2 alternative reconstructive methods: keystone flap and rotational flap.
Twenty-four late stage breast cancer patients with symptoms of cancer wounds were included in this study. They were divided into 2 groups: keystone flap and rotational flap. Each patient's QoL was evaluated using EORTC QLQ-C30 and QLQ-BR23 before and 3 weeks after surgery.
Global health post-surgery was significantly improved compared with pre-surgery in all patients ( < 0.001), across both the keystone ( = 0.018) and rotational groups ( = 0.007). Breast symptoms post-surgery were also improved compared with pre-surgery in all patients ( = 0.035). However, when analyzed per group, breast symptoms were only improved significantly in the keystone group ( = 0.013) but not in the rotational group ( = 0.575). When compared between 2 groups, future perspective post-surgery in the keystone group [100 (0-100)] was better than the rotational group [66.7 (0-100)], ( = 0.020).
Reconstructive surgery after mastectomy improves QoL in late stage breast cancer patients. The keystone flap is superior to the rotational flap in improving global health and breast symptoms.
晚期乳腺癌会出现恶性伤口，导致皮肤浸润、疼痛、出血和恶臭，影响生活质量（QoL）。姑息性乳房切除术旨在消除伤口症状，需要长期伤口护理以改善生活质量。本研究旨在前瞻性调查两种替代重建方法（梯形皮瓣和旋转皮瓣）在生活质量方面的差异。
本研究纳入了24例有癌症伤口症状的晚期乳腺癌患者。他们被分为两组：梯形皮瓣组和旋转皮瓣组。在手术前和手术后3周，使用欧洲癌症研究与治疗组织生活质量核心问卷（EORTC QLQ-C30）和乳腺癌特异性问卷（QLQ-BR23）对每位患者的生活质量进行评估。
所有患者术后的总体健康状况与术前相比均有显著改善（<0.001），梯形皮瓣组（=0.018）和旋转皮瓣组（=0.007）均如此。所有患者术后的乳房症状与术前相比也有所改善（=0.035）。然而，按组分析时，乳房症状仅在梯形皮瓣组有显著改善（=0.013），而在旋转皮瓣组未改善（=0.575）。两组比较时，梯形皮瓣组术后的未来展望[100（0 - 100）]优于旋转皮瓣组[66.7（0 - 100）]，（=0.020）。
乳房切除术后的重建手术可改善晚期乳腺癌患者的生活质量。梯形皮瓣在改善总体健康状况和乳房症状方面优于旋转皮瓣。
