背景:这项研究的目的是比较局部晚期乳腺癌患者的即时乳房重建(IBR)和单独乳房切除术的安全性和有效性结果。
方法:我们对PUBMED进行了全面的文献检索,EMBASE,和Cochrane数据库。评估的主要结果是总生存率,无病生存,局部复发。次要结果是手术并发症的发生率。所有数据均使用ReviewManager5.3进行分析。
结果:16项研究,本荟萃分析纳入了15,364名参与者.汇总数据表明,接受IBR的患者比仅接受乳房切除术的患者更容易出现手术并发症(HR:3.96,95CI[1.07,14.67],p=0.04)。总生存率无显著差异(HR:0.94,95CI[0.73,1.20],p=0.62),无病生存率(HR:1.03,95CI[0.83,1.27],p=0.81),或乳腺癌特异性生存率(HR:0.93,95CI[0.71,1.21],IBR组和非IBR组之间的p=0.57)。
结论:我们的研究表明,乳房切除术后的IBR不影响局部晚期乳腺癌患者的总生存期和无病生存期。然而,IBR带来了不可忽视的更高的并发症风险,需要充分评估和仔细决定。
BACKGROUND: The purpose of this study was to compare safety and efficacy outcomes between immediate breast reconstruction (IBR) and
mastectomy alone in locally advanced breast cancer patients.
METHODS: We conducted a comprehensive literature search of PUBMED, EMBASE, and Cochrane databases. The primary outcomes evaluated were overall survival, disease-free survival, and local recurrence. The secondary outcome was the incidence of surgical complications. All data were analyzed using Review Manager 5.3.
RESULTS: Sixteen studies, involving 15,364 participants were included in this meta-analysis. Pooled data demonstrated that patients underwent IBR were more likely to experience surgical complications than those underwent
mastectomy alone (HR: 3.96, 95%CI [1.07,14.67], p = 0.04). No significant difference was found in overall survival (HR: 0.94, 95%CI [0.73,1.20], p = 0.62), disease-free survival (HR: 1.03, 95%CI [0.83,1.27], p = 0.81), or breast cancer specific survival (HR: 0.93, 95%CI [0.71,1.21], p = 0.57) between IBR group and Non-IBR group.
CONCLUSIONS: Our study demonstrates that IBR after
mastectomy does not affect the overall survival and disease-free survival of locally advanced breast cancer patients. However, IBR brings with it a nonnegligible higher risk of complications and needs to be fully evaluated and carefully decided.