Zhang Yalan, Liu Fan, Gao Qianqian, Chai Yahui, Ren Yan, Tian Hongyou, Ma Bin, Song Ailin
Department of General Surgery, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, China.
Second Clinical Medical College, Lanzhou University, Lanzhou, China.
Front Oncol. 2022 Dec 16;12:1042789. doi: 10.3389/fonc.2022.1042789. eCollection 2022.
This systematic review and meta-analysis compares the outcome between MMBC and unifocal breast cancer (UFBC), in order to provide a theoretical basis for the design of an appropriate clinical therapeutic strategy of MMBC patients.
PubMed, Embase, The Cochrane Library, Web of science, CNKI, WanFang Data, CBM and VIP database were searched from inception to July 2021, and observational studies reporting the outcome of patients with MMBC and UFBC were included. We extracted or calculated the mortality rates of MMBC and UFBC patients; and obtained the hazard ratios; odds ratios; relative risks; and the corresponding 95% confidence intervals from the eligible studies. All the meta-analyses were conducted by using the Stata 15.0 software.
31 eligible studies comprising a total of 15,703 individuals were included. The meta-analysis revealed that MMBC did not have a significant association with poor overall survival (=1.04, 95% =0.96-1.12), disease-free survival (= 1.07, 95% = 0.84-1.36), breast cancer-specific survival (=1.42, 95% = 0.89-2.27), recurrence-free survival (= 0.878, 95% = 0.652-1.182), local recurrence-free survival (= 0.90, 95% = 0.57-1.42), and contralateral breast cancer risk (= 0.908, 95% = 0.667-1.234). However, MMBC appeared to have a correlation with a slightly higher risk of death (=1.31, 95% =1.18-1.45).
Patients with MMBC appeared to have a higher risk of death, however, it may not be independently associated with poorer outcomes. Considering the inter-study heterogeneity and other limitations, our results need to be validated by further multicenter prospective studies with a large sample size in the future.
本系统评价和荟萃分析比较了多灶性乳腺癌(MMBC)和单灶性乳腺癌(UFBC)的预后,以便为MMBC患者制定合适的临床治疗策略提供理论依据。
检索了PubMed、Embase、Cochrane图书馆、Web of science、中国知网、万方数据、中国生物医学文献数据库和维普数据库,检索时间从建库至2021年7月,纳入报告MMBC和UFBC患者预后的观察性研究。我们提取或计算了MMBC和UFBC患者的死亡率;并从符合条件的研究中获得风险比、比值比、相对风险以及相应的95%置信区间。所有荟萃分析均使用Stata 15.0软件进行。
纳入31项符合条件的研究,共15703例个体。荟萃分析显示,MMBC与总体生存率差(=1.04,95%=0.96-1.12)、无病生存率(=1.07,95%=0.84-1.36)、乳腺癌特异性生存率(=1.42,95%=0.89-2.27)、无复发生存率(=0.878,95%=0.652-1.182)、局部无复发生存率(=0.90,95%=0.57-1.42)和对侧乳腺癌风险(=0.908,95%= ) 0.667-1.234)无显著关联。然而,MMBC似乎与死亡风险略高(=1.31,95%=1.18-1.45)相关。
MMBC患者似乎有较高的死亡风险,然而,它可能与较差的预后无独立关联。考虑到研究间的异质性和其他局限性,我们的结果需要未来通过进一步的大样本多中心前瞻性研究进行验证。