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乳腺癌保乳手术后患者的生活质量:系统评价和荟萃分析。

Quality of Life in Patients with Breast Cancer following Breast Conservation Surgery: A Systematic Review and Meta-Analysis.

机构信息

Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin City, Heilongjiang Province, China.

Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, Heilongjiang Province, China.

出版信息

J Healthc Eng. 2022 Jan 31;2022:3877984. doi: 10.1155/2022/3877984. eCollection 2022.

Abstract

To evaluate the health-related quality-of-life (QOL) outcomes in surgical breast cancer survivors who received breast conservation therapy (BCT) compared to mastectomy, we utilized a systematic review to conduct observational studies of QOL in patients with breast cancer following breast conservation therapy from their inception until October 2021. The PubMed, the Cochrane Library, and the Web of Science databases were systematically searched to retrieve the observational studies. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were applied as an effect estimate and calculated using Stata 15 software. Nine studies comprising 2301 patients were included. The results showed that no significant differences compared to mastectomy were detected for global health status (=0.971 and =0.613), physical function (=0.099), emotional function (=0.096), cognitive function (=0.377), social function (=0.602), sexual functioning (=0.072), and sexual enjoyment (=0.142), while role function (=0.036), body image (=0.000), and future perspective (=0.012) showed a significant difference for BCT when compared to mastectomy. When compared to breast reconstruction (BR), the BCT group was inferior at physical function (=0.002) and cognitive function (=0.040) but superior at body image (=0.001). When used the Functional Assessment of Cancer Therapy (FACT) tool, BCT has better results in physical function (=0.000), emotional function (=0.000), and social function (=0.000) than mastectomy. QOL outcomes after BCT were better than mastectomy in body image, future perspective, and role function. BCT may be an acceptable option in the study setting for breast cancer patients who pursue high QOL.

摘要

为了评估接受保乳治疗(BCT)的手术乳腺癌幸存者与接受乳房切除术相比的健康相关生活质量(QOL)结局,我们利用系统评价对从 BCT 开始至 2021 年 10 月期间接受 BCT 的乳腺癌患者的 QOL 进行了观察性研究。我们系统地检索了 PubMed、Cochrane 图书馆和 Web of Science 数据库,以获取观察性研究。使用 Stata 15 软件计算和应用合并的比值比(OR)及其 95%置信区间(CI)作为效应估计值。共纳入 9 项研究,包含 2301 例患者。结果显示,与乳房切除术相比,BCT 在总体健康状况(OR=0.971,OR=0.613)、生理功能(OR=0.099)、情感功能(OR=0.096)、认知功能(OR=0.377)、社会功能(OR=0.602)、性功能(OR=0.072)和性享受(OR=0.142)方面无显著差异,而在角色功能(OR=0.036)、身体意象(OR=0.000)和未来展望(OR=0.012)方面则存在显著差异。与乳房重建(BR)相比,BCT 组在生理功能(OR=0.002)和认知功能(OR=0.040)方面表现较差,但在身体意象(OR=0.001)方面表现较好。当使用癌症治疗功能评估(FACT)工具时,BCT 在生理功能(OR=0.000)、情感功能(OR=0.000)和社会功能(OR=0.000)方面的结果优于乳房切除术。BCT 在身体意象、未来展望和角色功能方面的 QOL 结局优于乳房切除术。BCT 可能是追求高 QOL 的乳腺癌患者在研究环境中的可接受选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85d8/8820849/a7359c119e4b/JHE2022-3877984.001.jpg

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