Sandwell and West Birmingham Hospitals, NHS Trust, Birmingham, United Kingdom.
Sandwell and West Birmingham Hospitals, NHS Trust, Birmingham, United Kingdom.
Surg Oncol. 2022 Jun;42:101779. doi: 10.1016/j.suronc.2022.101779. Epub 2022 May 10.
To evaluate comparative outcomes of oncoplastic breast conserving surgery (OBCS) versus conventional breast conserving surgery (BCS) for breast cancer treatment.
A systematic search of multiple electronic data sources was conducted, and all eligible studies comparing OBCS and BCS were included. Characteristics of the tumour includes preoperative size of tumour on imaging and the weight of the specimen after resection. While positive margins rate, re-excision rate, completion mastectomy rate and loco-regional recurrence were considered as oncological outcome parameters. Post-operative complications include surgical site infection (SSI), seroma, haematoma and skin/nipple necrosis.
Thirty-one studies reporting a total number of 115011 patients who underwent OBCS (n = 11978) or BCS (n = 103033) were included. OBCS group showed lower risk of positive margins rate [OR 0.76, P = 0.05], re-excision rate [OR 0.72, P = 0.02], and loco-regional recurrence [OR 0.62, P = 0.03] compared to BCS group. There was no significant difference between the two groups regarding post-operative complications.
Although there is a lack of level 1 evidence, the available studies clearly demonstrate superior or at least equivalent outcomes when comparing OBCS with conventional BCS. The benefits of OBCS include dealing with larger tumours, wider surgical margins and better aesthetic results for patients.
评估保乳肿瘤整形术(OBCS)与常规保乳术(BCS)治疗乳腺癌的比较结果。
系统检索多个电子数据库,并纳入所有比较 OBCS 和 BCS 的合格研究。肿瘤特征包括术前影像学上肿瘤的大小和切除后标本的重量。阳性切缘率、再次切除术率、完成乳房切除术率和局部区域复发率被视为肿瘤学结果参数。术后并发症包括手术部位感染(SSI)、血清肿、血肿和皮肤/乳头坏死。
共纳入 31 项研究,报告了 115011 例接受 OBCS(n=11978)或 BCS(n=103033)的患者。与 BCS 组相比,OBCS 组的阳性切缘率[OR 0.76,P=0.05]、再次切除术率[OR 0.72,P=0.02]和局部区域复发率[OR 0.62,P=0.03]的风险较低。两组之间术后并发症无显著差异。
尽管缺乏 1 级证据,但现有研究清楚地表明,与常规 BCS 相比,OBCS 的结果更优或至少相当。OBCS 的优点包括处理更大的肿瘤、更宽的手术切缘和为患者提供更好的美容效果。