Kuo Wen-Ling, Huang Jung-Ju, Chu Chia-Huei, Chang Shu-Chen, Lin Yu-Jr, Chuang Yu-Hsuan, Li Yu-Chieh, Cheong Chon-Fok, Liu Yu-Ling, Chen Shin-Cheh
Division of Breast Surgery, General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taipei and Taoyuan City, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; School of Medicine, National Tsing-Hua University, Hsin-Chu, Taiwan.
School of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Reconstruction and Microsurgery, Plastic Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
Eur J Surg Oncol. 2025 May;51(5):109622. doi: 10.1016/j.ejso.2025.109622. Epub 2025 Jan 21.
This study aimed to compare the surgical and oncological outcomes of robotic mastectomy (RM) and conventional mastectomy (CM) for breast cancer.
Our institutional registry of women with breast cancer who received RM between 2018 and 2023 and CM between 2016 and 2023 were reviewed. Propensity score matching of clinicopathological variables was used to match 123 RM patients with 123 CM patients. Surgical outcomes, reconstruction type, margin status, complications, recurrence-free survival (RFS), and overall survival (OS) were compared between the 2 groups. Complications with increasing RM experience were also examined.
More autologous flap reconstructions were used in RM (67 % vs. 39 %, p < 0.001), but more implant reconstructions were used in CM (61 % vs. 33 %, p < 0.001). The complication rate, especially breast skin necrosis, was lower in the RM group (10 % vs. 26 %, p = 0.002). Nipple-areolar complex necrosis in nipple-sparing mastectomy was similar between the groups (33 % vs. 27 %, p = 0.45). At a median follow-up of 30 months, RFS was comparable between the 2 groups, as was OS (median follow-up 36 months). More RM experience was associated with shorter operation time and lower surgical complication and margin positive rates.
The oncological outcomes of RM and CM are similar at a follow-up of about 3 years. RM is associated with a significantly lower rate of breast skin necrosis, and the advantage of RM exists with different types of breast reconstruction. Increasing RM experience leads to improved overall results.
本研究旨在比较机器人乳房切除术（RM）和传统乳房切除术（CM）治疗乳腺癌的手术及肿瘤学结局。
回顾了我院2018年至2023年接受RM以及2016年至2023年接受CM的乳腺癌女性患者的登记资料。采用倾向评分匹配临床病理变量，将123例RM患者与123例CM患者进行匹配。比较两组的手术结局、重建类型、切缘状态、并发症、无复发生存期（RFS）和总生存期（OS）。还研究了随着RM经验增加并发症的情况。
RM组更多采用自体皮瓣重建（67%对39%，p<0.001），但CM组更多采用植入物重建（61%对33%，p<0.001）。RM组的并发症发生率，尤其是乳腺皮肤坏死率较低（10%对26%，p=0.002）。保乳手术中乳头乳晕复合体坏死在两组间相似（33%对27%，p=0.45）。中位随访30个月时，两组的RFS相当，OS也相当（中位随访36个月）。更多的RM经验与更短的手术时间、更低的手术并发症和切缘阳性率相关。
在约3年的随访中，RM和CM的肿瘤学结局相似。RM与乳腺皮肤坏死率显著降低相关，且RM在不同类型的乳房重建中均具有优势。增加RM经验可改善总体结果。
