Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland.
Breast Center, University Hospital of Basel, Basel, Switzerland.
Breast Cancer Res Treat. 2023 Jan;197(2):333-341. doi: 10.1007/s10549-022-06811-0. Epub 2022 Nov 20.
The aim of the study was to analyze the impact of neoadjuvant systemic treatment (NST) on postoperative complications and the beginning of adjuvant treatment.
This study includes data from a prospectively maintained database including patients with breast cancer (BC) stage I-IV with or without NST undergoing breast cancer surgery between January 2010 and September 2021.
Out of 517 enrolled patients, 77 received NST, 440 had primary breast surgery. After NST patients underwent surgery after a meantime of 34 days (26.5-40 days). No statistical significance could be found comparing the complication grading according to the Clavien Dindo classification. The complications were most frequently rated as grade 3b. There were no complications with grade 4 or higher. When differentiating into short and long-term, the overall rate of short-term complications was 20.3% with no significant difference between the two groups (20.8% vs. 20.2%). Regarding long-term complications, there was more impairment of shoulder mobility (26.0% vs. 9.5%, p ≤ 0.001) and chronic pain (42.9% vs. 28.6%, p ≤ 0.016) for patients with NST. The beginning of the administration of the adjuvant treatment was comparable in both groups (46.3 days vs. 50.5 days).
In our cohort, complications between both groups were comparable according to Clavien Dindo. This study shows that NST has no negative impact on postoperative short-term complications and most importantly did not lead to a delay of the beginning of adjuvant treatment. Therefore, NST can be safely admitted, even when followed by extensive breast reconstruction surgery.
本研究旨在分析新辅助全身治疗（NST）对术后并发症和辅助治疗开始的影响。
本研究纳入了 2010 年 1 月至 2021 年 9 月期间接受乳腺癌手术且接受或未接受 NST 的 I-IV 期乳腺癌患者的前瞻性维护数据库中的数据。
在 517 名入组患者中，77 名患者接受了 NST，440 名患者接受了原发性乳腺癌手术。在接受 NST 治疗的患者中，手术后的时间间隔为 34 天（26.5-40 天）。根据 Clavien Dindo 分类比较并发症分级，无统计学意义。并发症最常被评为 3b 级。没有 4 级或更高的并发症。当分为短期和长期时，短期并发症的总发生率为 20.3%，两组之间无显著差异（20.8% vs. 20.2%）。关于长期并发症，接受 NST 的患者肩部活动受限（26.0% vs. 9.5%，p≤0.001）和慢性疼痛（42.9% vs. 28.6%，p≤0.016）的发生率更高。两组辅助治疗开始的时间无差异（46.3 天 vs. 50.5 天）。
在我们的队列中，根据 Clavien Dindo，两组之间的并发症相当。本研究表明，NST 对术后短期并发症没有负面影响，最重要的是不会导致辅助治疗开始时间的延迟。因此，即使随后进行广泛的乳房重建手术，也可以安全地进行 NST。
