Immediate Breast Reconstruction After Neoadjuvant Chemotherapy
Immediate Breast Reconstruction After Neoadjuvant Chemotherapy
复制标题
新辅助化疗后立即进行乳房重建
作者：
W. Chi;Qi Zhang;Lun Li;Ming Chen;B. Xiu;Benlong Yang;Jiong Wu
乳房再造已成为乳腺癌治疗的一个组成部分，特别是对于新辅助化疗（NAC）后无法接受保乳手术的患者。我们分析了影响NAC后立即重建手术类型的因素，以及每种手术类型的并发症发生率。方法本研究纳入2010年至2021年接受NAC后乳房切除术的乳腺癌患者。分析了接受自体组织重建（ATR，n = 127）、基于植入物的重建（IBR，n = 60）和自体组织和植入物联合重建（n = 60）的患者的临床病理学特征、计划外再手术率和术后住院时间。结果共纳入1651例术前接受NAC治疗的乳腺癌患者。其中，247例（15.0%）患者接受了立即再造（IR），而1404例仅接受乳房切除术。IR组患者较非IR组年轻（P < 0.001），体重指数较低（P < 0.001），临床分期（P = 0.003）和淋巴结分期（P < 0.001）较早。ATR组患者年龄较大（P < 0.001），体重指数较高（P = 0.007），肿瘤较大（P = 0.024），生育史较频繁（P = 0.011）。IBR组中导致计划外再次手术的并发症更常见（P = 0.039）。ATR术后住院时间最长（P = 0.008）。结论年龄和临床肿瘤/淋巴结分期与NAC后行乳腺切除术患者的IR相关。对于NAC后接受IR的患者，ATR可能比IBR更安全和更适合。
Background Breast reconstruction has become an integral component of breast cancer treatment, especially for patients who are unable to undergo breast-conserving surgery after neoadjuvant chemotherapy (NAC). We analyzed factors influencing the type of immediate reconstruction surgery after NAC, as well as the complication rates for each surgery type. Methods The study included patients with breast cancer who underwent mastectomy following NAC from 2010 to 2021. Clinicopathological characteristics, unplanned reoperation rates, and the duration of postoperative hospitalization were analyzed in patients undergoing autologous tissue reconstruction (ATR, n = 127), implant-based reconstruction (IBR, n = 60), and combined autologous tissue and implant reconstruction (n = 60). Results A total of 1651 patients who received NAC before mastectomy were enrolled. Among them, 247 (15.0%) patients underwent immediate reconstruction (IR), whereas 1404 underwent mastectomy only. Patients in the IR group were younger (P < 0.001), had lower body mass index (P < 0.001), and exhibited earlier clinical (P = 0.003) and nodal (P < 0.001) stage than those in the non-IR group. Patients in the ATR group were older (P < 0.001) and had higher body mass index (P = 0.007), larger tumor size (P = 0.024), and more frequent childbearing history (P = 0.011) than those in the other groups. Complications resulting in unplanned reoperations were more frequent in the IBR group (P = 0.039). The duration of postoperative hospitalization was longest after ATR (P = 0.008). Conclusions Age and clinical tumor/nodal stage at presentation are associated with IR for patients undergoing mastectomy after NAC. For patients undergoing IR after NAC, ATR may be safer and more suitable than IBR.
DOI：
10.1093/oxfordjournals.jncimonographs.a003469
发表时间：
2001-12
期刊：
Journal of the National Cancer Institute. Monographs
影响因子：
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作者：
N. Wolmark;Jiping Wang;E. Mamounas;J. Bryant;B. Fisher
通讯作者：
N. Wolmark;Jiping Wang;E. Mamounas;J. Bryant;B. Fisher