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肿瘤整形乳房手术与传统保乳手术治疗乳腺癌的长期肿瘤学结局比较:一项倾向评分匹配分析

Comparison of Long-Term Oncological Outcomes in Oncoplastic Breast Surgery and Conventional Breast-Conserving Surgery for Breast Cancer: A Propensity Score-Matched Analysis.

作者信息

Oh Moon Young, Kim Yumi, Kim Jiho, Cheun Jong-Ho, Jung Ji Gwang, Kim Hong-Kyu, Lee Han-Byoel, Han Wonshik

机构信息

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea.

出版信息

J Breast Cancer. 2021 Dec;24(6):520-530. doi: 10.4048/jbc.2021.24.e52.

Abstract

PURPOSE

The oncoplastic breast-conserving surgery (OPS) technique, combined with the principles of oncological safety and plastic surgery, results in complete tumor resection while preserving the natural appearance of the breast. The purpose of this study was to evaluate the long-term oncological results after OPS compared with conventional breast-conserving surgery (BCS) for early breast cancer.

METHODS

The medical records of patients who underwent breast cancer surgery and adjuvant radiation therapy at Seoul National University Hospital between 2011 and 2014 were reviewed. Ipsilateral breast tumor recurrence (IBTR)-free survival rate and recurrence-free survival (RFS) rates were compared between the OPS and BCS groups.

RESULTS

One-to-one propensity score matching was conducted, yielding 371 patients in each group. The mean tumor distance from the nipple was shorter, and the mean retrieved specimen size and pathologic tumor size, including ductal carcinoma in situ, were larger in the OPS group than in the conventional BCS group ( < 0.001). Surgical margin positivity was not significantly different between the two groups ( = 0.777). The surgical technique was not significantly associated with IBTR (OPS versus conventional BCS, 5-year survival rate, 96.9% vs. 98.6%; = 0.355) and RFS (5-year survival rate, 92.9% vs. 94.5%; = 0.357) on the log-rank test. Multivariate analysis revealed that OPS versus conventional BCS was not significantly associated with survival outcomes.

CONCLUSION

We observed no significant differences in long-term IBTR and RFS between the OPS and conventional BCS groups in this retrospective analysis. OPS can be an oncologically and surgically safe alternative option for conventional BCS for early breast cancer.

摘要

目的

肿瘤整形保乳手术(OPS)技术结合了肿瘤学安全性和整形外科学原理,在保留乳房自然外观的同时实现肿瘤的完整切除。本研究旨在评估早期乳腺癌患者接受OPS与传统保乳手术(BCS)后的长期肿瘤学结果。

方法

回顾了2011年至2014年在首尔国立大学医院接受乳腺癌手术及辅助放疗的患者的病历。比较了OPS组和BCS组的同侧乳腺肿瘤复发(IBTR)无生存率和无复发生存率(RFS)。

结果

进行了一对一倾向评分匹配,每组产生371例患者。OPS组肿瘤距乳头的平均距离较短,包括导管原位癌在内的平均切除标本大小和病理肿瘤大小均大于传统BCS组(<0.001)。两组手术切缘阳性率无显著差异(=0.777)。对数秩检验显示手术技术与IBTR(OPS与传统BCS,5年生存率,96.9%对98.6%;=0.355)和RFS(5年生存率,92.9%对94.5%;=0.357)无显著相关性。多因素分析显示,OPS与传统BCS与生存结果无显著相关性。

结论

在这项回顾性分析中,我们观察到OPS组和传统BCS组在长期IBTR和RFS方面无显著差异。对于早期乳腺癌,OPS对于传统BCS而言在肿瘤学和手术方面是一种安全的替代选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/392f/8724379/048874f00f86/jbc-24-520-g001.jpg

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