对侧预防性乳房切除术对单侧乳腺癌患者生存结局的影响：一项系统评价和荟萃分析。

Impact of contralateral prophylactic mastectomy on survival outcomes in patients with unilateral breast cancer: A systematic review and meta-analysis.

作者信息

Yao Min, Peng Puchao, Chen Lijie, Xu Zhouming

机构信息

Min Yao, Department of Breast Surgery, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province 313000, P.R. China.

Puchao Peng, Department of Breast Surgery, Huzhou Maternity & Child Health Care Hospital, Huzhou, Zhejiang Province 313000, P.R. China.

出版信息

Pak J Med Sci. 2024 Sep;40(8):1873-1881. doi: 10.12669/pjms.40.8.9708.

DOI:10.12669/pjms.40.8.9708

PMID:39281219

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11395362/

Abstract

OBJECTIVE

To synthesize contemporary evidence of the impact of contralateral prophylactic mastectomy (CPM) on survival outcomes in patients with unilateral breast cancer (UBC).

METHODS

PubMed, EMBASE and Scopus databases were searched for observational studies published up to November 15, 2023. Random-effects model was used to obtain pooled effect estimates that were reported as hazards ratio (HR) with 95% confidence intervals (CI). The outcomes of interest were overall survival (OS), breast cancer-specific survival (BCSS), recurrence free survival (RFS) and risk of contralateral breast cancer (CBC).

RESULTS

Twenty-one studies were included. Most studies had a retrospective design. CPM was associated with significant improvement of OS (HR 0.80, 95% CI: 0.75, 0.85), BCCS (HR 0.82, 95% CI: 0.74, 0.90), and RFS (HR 0.72, 95% CI: 0.60, 0.86) and significantly reduced risk of CBC (HR 0.05, 95% CI: 0.03, 0.09) in patients with UBC. No evidence of publication bias was detected.

CONCLUSION

Our results provide strong evidence supporting the positive impact of CPM on survival outcomes in patients with UBC. Further research and long-term follow-up studies are warranted to validate these findings.

摘要

目的

综合当代关于对侧预防性乳房切除术（CPM）对单侧乳腺癌（UBC）患者生存结局影响的证据。

方法

检索了PubMed、EMBASE和Scopus数据库中截至2023年11月15日发表的观察性研究。采用随机效应模型获得合并效应估计值，以风险比（HR）及95%置信区间（CI）报告。感兴趣的结局包括总生存期（OS）、乳腺癌特异性生存期（BCSS）、无复发生存期（RFS）和对侧乳腺癌（CBC）风险。

结果

纳入21项研究。大多数研究为回顾性设计。CPM与UBC患者的OS（HR 0.80，95%CI：0.75，0.85）、BCCS（HR 0.82，95%CI：0.74，0.90）和RFS（HR 0.72，95%CI：0.60，0.86）显著改善以及CBC风险显著降低（HR 0.05，95%CI：0.03，0.09）相关。未检测到发表偏倚的证据。