真空辅助切除：一种用于乳腺叶状肿瘤诊断和治疗的安全微创选择——系统评价与Meta分析

Vacuum-assisted excision: a safe minimally invasive option for benign phyllodes tumor diagnosis and treatment-a systematic review and meta-analysis.

作者信息

Gil Maria Luísa Braga Vieira, Coelho Bertha Andrade, Couto Henrique Lima, Silva Henrique Moraes Salvador, Pessoa Eduardo Carvalho, Sharma Nisha, Mann Ritse, McIntosh Stuart A, Diniz Paulo Henrique Costa, Cantidio Farley Soares, Gil Gabriel Oliveira Bernardes, Salvador Anna Dias, de Almeida Júnior Waldeir José, Avelar José Tadeu Campos, Laranjeira Cláudia Lourdes Soares, Silva Filho Agnaldo Lopes

机构信息

Mastology Department, Rede Mater Dei de Saúde, Belo Horizonte, Minas Gerais, Brazil.

Breast Imaging Department, Brazilian Society of Mastology, Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Front Oncol. 2024 May 14;14:1394116. doi: 10.3389/fonc.2024.1394116. eCollection 2024.

DOI:10.3389/fonc.2024.1394116

PMID:38807769

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11130386/

Abstract

SYNOPSIS

This is a systematic review and meta-analysis comparing surgical excision with percutaneous ultrasound-guided vacuum-assisted excision (US-VAE) for the treatment of benign phyllodes tumor (PT) using local recurrence (LR) as the endpoint.

OBJECTIVE

To determine the frequency of local recurrence (LR) of benign phyllodes tumor (PT) after ultrasound-guided vacuum-assisted excision (US-VAE) compared to the frequency of LR after surgical excision.

METHOD

A systematic review and meta-analysis [following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard] was conducted by comparing LR in women older than 18 years treated for benign PT by US-VAE compared with local surgical excision with at least 12 months of follow-up. Studies were retrieved from PubMed, Scopus, Web of Science, and Embase. The pooled effect measure used was the odds ratio (OR) of recurrence.

RESULTS

Five comparative prospective or retrospective observational studies published between January 1, 1992, and January 10, 2022, comparing surgical excision with percutaneous US-VAE for LR of benign PT met the selection criteria. Four were retrospective observational cohorts, and one was a prospective observational cohort. A total of 778 women were followed up. Of them, 439 (56.4%) underwent local surgical excision, and 339 (43.6%) patients had US-VAE. The median age of patients in the five studies ranged from 33.7 to 39 years; the median size ranged from 1.5 cm to 3.0 cm, and the median follow-up ranged from 12 months to 46.6 months. The needle gauge ranged from 7G to 11G. LR rates were not statically significant between US-VAE and surgical excision (41 of 339 34 of 439; OR 1.3; p = 0.29).

CONCLUSION

This meta-analysis suggests that using US-VAE for the removal of benign PT does not increase local regional recurrence and is a safe minimally invasive therapeutic option.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42022309782.

摘要

这是一项系统评价和荟萃分析，以局部复发（LR）为终点，比较手术切除与经皮超声引导下真空辅助切除（US-VAE）治疗良性叶状肿瘤（PT）的效果。

目的

确定与手术切除后相比，超声引导下真空辅助切除（US-VAE）治疗良性叶状肿瘤（PT）后的局部复发（LR）频率。

方法

进行了一项系统评价和荟萃分析[遵循系统评价和荟萃分析的首选报告项目（PRISMA）标准]，比较年龄超过18岁的接受US-VAE治疗良性PT的女性与接受局部手术切除且至少随访12个月的女性的LR情况。研究从PubMed、Scopus、科学网和Embase中检索。使用的合并效应量是复发的比值比（OR）。

结果

1992年1月1日至2022年1月10日期间发表的五项比较手术切除与经皮US-VAE治疗良性PT的LR的前瞻性或回顾性观察性研究符合入选标准。四项是回顾性观察队列，一项是前瞻性观察队列。总共对778名女性进行了随访。其中，439名（56.4%）接受了局部手术切除，339名（43.6%）患者接受了US-VAE。五项研究中患者的中位年龄在33.7至39岁之间；中位大小在1.5厘米至3.0厘米之间，中位随访时间在12个月至46.6个月之间。针号范围为7G至11G。US-VAE与手术切除之间的LR率无统计学显著差异（339例中有41例，439例中有34例；OR 1.3；p = 0.29）。