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浸润性乳腺癌保乳术后的腔镜下切缘处理:标本体积减小,切缘阳性率降低。

Cavity shaving for invasive breast cancer conservative surgery: Reduced specimen volume and margin positive rates.

机构信息

Surgery Department. Hospital Clínico Universitario "Virgen de La Arrixaca". Murcia. Spain. Instituto Murciano de Investigación Biosanitaria (IMIB), Spain.

Biostatistics Department. Fundación para la Formación e Investigación Sanitaria (FFIS), Murcia, Spain.

出版信息

Surg Oncol. 2021 Sep;38:101632. doi: 10.1016/j.suronc.2021.101632. Epub 2021 Jul 14.

Abstract

INTRODUCTION

The cavity shaving (CS) technique was described in breast conserving surgery to reduce the rate of reoperation avoiding the need for intraoperative margin analysis. This study assesses differences in the rates of involvement of the surgical margin (requiring further surgery) and volume of surgical specimens, depending on the use or not of this technique.

MATERIAL AND METHODS

A retrospective cohort study was conducted in patients with breast carcinoma who underwent breast conserving surgery between 2013 and 2019. They were divided into two groups depending on whether the cavity shaving technique was used or not. Primary outcomes of the study included presence of final margin involvement, requiring need for further surgery, and the volume of excised tissue comparing the study groups.

RESULTS

A total of 202 cases were included: 92 in the control group and 110 in the cavity shaving group. Significant differences were found regarding involvement of the final margin (19.57% control group vs. 4.55% cavity shaving group; p = 0.010). The volume of additional surgical specimens were significantly greater in the traditional technique group than in the shaving technique (46.43 vs 13.32 cm; p = 0.01) as was total specimen volume (143.40 vs 100.63 cm; p = 0.022).

CONCLUSIONS

CS can reduce the positive margin and re-excision rates without larger-volume resections and should therefore be considered a routine technique in BCS for early-stage breast cancer.

摘要

引言

腔面刮除(CS)技术在保乳手术中被描述为降低再次手术率,避免术中切缘分析的需要。本研究评估了根据是否使用该技术,手术切缘(需要进一步手术)的累及率和手术标本体积的差异。

材料与方法

这是一项回顾性队列研究,纳入了 2013 年至 2019 年间接受保乳手术的乳腺癌患者。根据是否使用腔面刮除技术将患者分为两组。研究的主要结局包括最终切缘受累的存在、需要进一步手术的情况以及比较两组研究的切除组织体积。

结果

共纳入 202 例患者:对照组 92 例,腔面刮除组 110 例。最终切缘受累方面存在显著差异(对照组为 19.57%,腔面刮除组为 4.55%;p=0.010)。传统技术组的额外手术标本体积明显大于刮除技术组(46.43 比 13.32 cm;p=0.01),总标本体积也明显大于刮除技术组(143.40 比 100.63 cm;p=0.022)。

结论

CS 可以降低阳性切缘和再次切除率,而不会增加更大体积的切除,因此应被视为早期乳腺癌保乳手术的常规技术。

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