对侧预防性乳房切除术对乳房切除时教科书式预后达成情况的影响。
Influence of contralateral prophylactic mastectomy on textbook outcome attainment at time of mastectomy.
作者信息
Aitken Gabriela L, Samuels Shenae, Gannon Christopher J, Llaguna Omar H
机构信息
Department of Surgery, Memorial Healthcare System, Hollywood, FL, USA.
Office of Human Research, Memorial Healthcare System, Hollywood, FL, USA.
出版信息
Am J Surg. 2024 Jan;227:111-116. doi: 10.1016/j.amjsurg.2023.09.050. Epub 2023 Oct 1.
INTRODUCTION
The objective of this study was to determine the incidence of textbook oncologic outcome (TOO) and its impact on overall survival (OS) among patients with invasive ductal carcinoma (IDC) following modified radical mastectomy (MRM) versus MRM with contralateral prophylactic mastectomy (MRM + CPM).
METHODS
The 2004-2017 National Cancer Database was queried for patients with IDC who underwent MRM and MRM + CPM. TOO was defined as: resection with negative margins, adequate lymphadenectomy, length of stay ≤50th percentile, and no 30-day readmission or mortality.
RESULTS
87,573 patients were identified, of which 14.3% underwent MRM + CPM. Logistic regression models revealed that MRM + CPM is independently associated with a reduced likelihood of achieving TOO (AOR = 0.71; P < 0.001). MRM patients who achieved TOO had a higher median OS compared to those who did not (164.6 vs.142.2 months, P < 0.001).
CONCLUSIONS
MRM + CPM is associated with a lower incidence of TOO attainment compared to MRM.
引言
本研究的目的是确定在接受改良根治性乳房切除术（MRM）与改良根治性乳房切除术加对侧预防性乳房切除术（MRM + CPM）的浸润性导管癌（IDC）患者中，教科书式肿瘤学结局（TOO）的发生率及其对总生存期（OS）的影响。
方法
查询2004 - 2017年国家癌症数据库中接受MRM和MRM + CPM的IDC患者。TOO定义为：切缘阴性切除、充分的淋巴结清扫、住院时间≤第50百分位数，且无30天再入院或死亡。
结果
共识别出87,573例患者，其中14.3%接受了MRM + CPM。逻辑回归模型显示，MRM + CPM与实现TOO的可能性降低独立相关（调整后比值比[AOR]=0.71；P<0.001）。实现TOO的MRM患者的中位总生存期高于未实现TOO的患者（164.6个月对142.2个月，P<0.001）。
结论
与MRM相比，MRM + CPM实现TOO的发生率较低。
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