Department of Medical Oncology, Jiangsu University Affiliated People's Hospital, Zhenjiang Clinical Medical College of Nanjing Medical University, Zhenjiang, China.
Department of Breast Surgery, Jiangsu University Affiliated People's Hospital, Zhenjiang, China.
Technol Cancer Res Treat. 2024 Jan-Dec;23:15330338241265030. doi: 10.1177/15330338241265030.
Mastectomy (MT) and breast conservation surgery (BCS) are two common surgical options for the treatment of locally advanced breast cancer (LABC). Neoadjuvant chemotherapy (NACT) is frequently administered before surgery to shrink tumors and improve surgical outcomes. However, there is a lack of consensus on the optimal surgical approach after NACT and its impact on survival outcomes.
This meta-analysis aims to compare the survival outcomes between MT and BCS in patients treated with NACT.
A PRISMA selection was used to identify studies across electronic database such as PubMed, and Cochrane Library from inception until 11 July, 2023. A total of 10 comparative studies involving a total of 5018 patients were included. Among them, 2898 patients underwent MT while 2120 underwent BCS after receiving NACT. The outcomes assessed were the 5-year overall survival (OS) and 5-year disease-free survival (DFS). The data from the included studies were pooled, and odds ratios (OR) with 95% confidence intervals (CI) were calculated to evaluate the differences between MT and BCS in terms of survival outcomes. Prospero: CRD42024496831.
The meta-analysis revealed that patients who underwent MT after NACT had a higher 5-year OS compared to those who underwent BCS (OR 2.68, 95% CI [2.19-3.28; p < 0.00001]). Additionally, the 5-year DFS was significantly better for patients who underwent MT (OR 3.11, 95% CI [1.80-5.38; p < 0.0001]).
MT after NACT may be associated with better 5-year OS and DFS compared to BCS.
乳房切除术（MT）和保乳手术（BCS）是治疗局部晚期乳腺癌（LABC）的两种常见手术选择。新辅助化疗（NACT）常用于手术前缩小肿瘤并改善手术结果。然而，对于 NACT 后最佳手术方法及其对生存结果的影响，目前尚无共识。
本荟萃分析旨在比较接受 NACT 治疗的患者中 MT 和 BCS 的生存结果。
采用 PRISMA 选择方法，从电子数据库（如 PubMed 和 Cochrane 图书馆）中检索从开始到 2023 年 7 月 11 日的研究。共纳入 10 项比较研究，共纳入 5018 例患者。其中，2898 例患者接受 MT，2120 例患者接受 NACT 后接受 BCS。评估的结局是 5 年总生存率（OS）和 5 年无病生存率（DFS）。对纳入研究的数据进行汇总，并计算比值比（OR）及其 95%置信区间（CI），以评估 MT 和 BCS 在生存结果方面的差异。Prospéro：CRD42024496831。
荟萃分析显示，接受 NACT 后行 MT 的患者 5 年 OS 高于接受 BCS 的患者（OR 2.68，95%CI [2.19-3.28;p<0.00001]）。此外，接受 MT 的患者 5 年 DFS 明显更好（OR 3.11，95%CI [1.80-5.38;p<0.0001]）。
与 BCS 相比，NACT 后行 MT 可能与更好的 5 年 OS 和 DFS 相关。
