三阴性乳腺癌即刻乳房重建的结局：倾向评分匹配分析。

Outcomes of Immediate Breast Reconstruction in Triple Negative Breast Cancer: A Propensity Score-Matched Analysis.

机构信息

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Ottawa, Canada.

Department of Plastic Surgery, Lenox Hill Hospital, New York, NY, USA.

出版信息

J Plast Reconstr Aesthet Surg. 2022 Aug;75(8):2542-2549. doi: 10.1016/j.bjps.2022.04.012. Epub 2022 Apr 21.

DOI:10.1016/j.bjps.2022.04.012

PMID:35599222

Abstract

PURPOSE

Triple negative breast cancer (TNBC) patients have a significantly worse prognosis and survival compared to non-TNBC patients. Mastectomy and immediate breast reconstruction (MIBR) is associated with higher rates of complications overall, but whether MIBR significantly increases oncological risk in TNBC patients has not been fully elucidated. Our study aimed to evaluate the oncological safety of MIBR in patients with TNBC compared to non-TNBC.

METHODS

A 6-year prospectively maintained retrospective database at The Ottawa Hospital was reviewed from January 1, 2013 to May 31, 2019. Propensity score-matching was performed using the nearest-neighbour method with a matching ratio of 2:1. Kaplan-Meier and log rank tests were performed to provide statistical comparison of disease-free interval (DFI). DFI was defined as time from MIBR to locoregional recurrence or disease-specific mortality. P-value < 0.05 indicated statistical significance.

RESULTS

Of 277 eligible patients, 153 patients were matched. The cohort consisted of 51(33%) TNBC patients and 102 (67%) non-TNBC patients after 2:1 propensity score-matching. The rates of delays to first radiochemotherapy [17 (33%) vs.14 (14%), p = 0.10], postoperative complications [13 (26%) vs. 34 (33%), p = 0.50], and locoregional recurrence [2 (1.96%) vs. 1 (1.96%), p = 1.0] were statistically similar in TNBC and non-TNBC, respectively. DFI was not significantly different in TNBC compared to non-TNBC patients (log-rank p = 1.0). There was no mortality in this cohort.

CONCLUSIONS

This 6-year retrospective 2:1 propensity score-matched cohort study demonstrated similar oncological safety for MIBR in patients with TNBC and non-TNBC. Overall, these findings provide additional support for the oncological safety of MIBR in TNBC. Therefore, MIBR remains a therapeutic option for patients with TNBC.

摘要

目的

与非三阴性乳腺癌（TNBC）患者相比，三阴性乳腺癌患者的预后和生存率明显更差。乳房切除术和即刻乳房重建（MIBR）总体上与更高的并发症发生率相关，但 MIBR 是否显著增加 TNBC 患者的肿瘤学风险尚未完全阐明。我们的研究旨在评估与非 TNBC 患者相比，MIBR 对 TNBC 患者的肿瘤学安全性。

方法

回顾性分析 2013 年 1 月 1 日至 2019 年 5 月 31 日期间渥太华医院的 6 年前瞻性维护回顾性数据库。采用最近邻法进行倾向评分匹配，匹配比例为 2:1。采用 Kaplan-Meier 法和对数秩检验比较无病间隔（DFI）的统计学差异。DFI 定义为从 MIBR 到局部区域复发或疾病特异性死亡的时间。P 值<0.05 表示具有统计学意义。

结果

在 277 名符合条件的患者中，有 153 名患者接受了匹配。在 2:1 倾向评分匹配后，队列包括 51 名（33%）TNBC 患者和 102 名（67%）非 TNBC 患者。两组患者首次放化疗延迟率[17 例（33%）比 14 例（14%），p=0.10]、术后并发症发生率[13 例（26%）比 34 例（33%），p=0.50]和局部区域复发率[2 例（1.96%）比 1 例（1.96%），p=1.0]差异无统计学意义。与非 TNBC 患者相比，TNBC 患者的 DFI 无显著差异（对数秩检验 p=1.0）。本队列无死亡病例。