Xiong Mingchen, Liu Zeming, Lv Wenchang, Zhao Chongru, Wang Yichen, Tan Yufang, Zhang Qi, Wu Yiping, Zeng Hong
Department of Plastic and Cosmetic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Surg. 2022 May 17;9:855999. doi: 10.3389/fsurg.2022.855999. eCollection 2022.
Tumors in the central and nipple portion (TCNP) are associated with poor prognosis and aggressive clinicopathological characteristics. The availability and safety of postmastectomy reconstruction in breast cancer patients with TCNP have still not been deeply explored. It is necessary to investigate whether reconstruction is appropriate for TCNP compared with non-reconstruction therapy in terms of survival outcomes.
Using the Surveillance, Epidemiology, and End Results (SEER) database, we enrolled TCNP patients diagnosed between the years 2010 and 2016. The propensity score matching (PSM) technique was applied to construct a matched sample consisting of pairs of non-reconstruction and reconstruction groups. Survival analysis was performed with the Kaplan-Meier method. Univariate and multivariate Cox proportional hazard models were applied to estimate the factors associated with breast cancer-specific survival (BCSS) and overall survival (OS).
In the overall cohort, a total of 6,002 patients were enrolled. The patients in the reconstruction group showed significantly better BCSS (log-rank, < 0.01) and OS (log-rank, < 0.01) than those in the non-reconstruction group (832 patients) after PSM. However, the multivariate Cox regression model revealed that breast reconstruction was not associated with worse BCSS and OS of TCNP patients.
Our study provided a new perspective showing that breast reconstruction did not affect the survival and disease prognosis in the cohort of TCNP patients from SEER databases, compared with non-reconstruction. This finding provides further survival evidence supporting the practice of postmastectomy reconstruction for suitable TCNP patients, especially those with a strong willingness for breast reconstruction.
乳房中央及乳头部位肿瘤(TCNP)与预后不良及侵袭性临床病理特征相关。对于患有TCNP的乳腺癌患者,乳房切除术后重建的可行性及安全性尚未得到深入研究。有必要探讨与非重建治疗相比,重建对于TCNP患者的生存结局是否合适。
利用监测、流行病学和最终结果(SEER)数据库,我们纳入了2010年至2016年间诊断为TCNP的患者。采用倾向评分匹配(PSM)技术构建由非重建组和重建组配对组成的匹配样本。采用Kaplan-Meier方法进行生存分析。应用单变量和多变量Cox比例风险模型来估计与乳腺癌特异性生存(BCSS)和总生存(OS)相关的因素。
在整个队列中,共纳入6002例患者。PSM后,重建组患者的BCSS(对数秩检验,<0.01)和OS(对数秩检验,<0.01)显著优于非重建组(832例患者)。然而,多变量Cox回归模型显示,乳房重建与TCNP患者较差的BCSS和OS无关。
我们的研究提供了一个新的视角,表明与非重建相比,乳房重建不影响SEER数据库中TCNP患者队列的生存和疾病预后。这一发现为适合的TCNP患者,尤其是那些有强烈乳房重建意愿的患者进行乳房切除术后重建的做法提供了进一步的生存证据。