Cavity Shaving plus Lumpectomy versus Lumpectomy Alone for Patients with Breast Cancer Undergoing Breast-Conserving Surgery: A Systematic Review and Meta-Analysis.
Cavity Shaving plus Lumpectomy versus Lumpectomy Alone for Patients with Breast Cancer Undergoing Breast-Conserving Surgery: A Systematic Review and Meta-Analysis.
复制标题
DOI：
10.1371/journal.pone.0168705
复制
发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
He J
中科院分区：
文献类型：
--
作者：
Wang K;Ren Y;He J
对于接受保乳手术 (BCS) 的患者来说，切缘状态是一个公认的预后预测指标。最近的数据表明，除了肿瘤切除术之外，腔体刮除术可能是改善临床结果的一种有前途的方法。我们的目的是通过系统评价和荟萃分析来比较腔体剃除术加肿瘤切除术和单独肿瘤切除术之间的疗效和安全性。我们检索了 PubMed、Embase 和 Cochrane CENTRAL 数据库，查找 2016 年 6 月 10 日之前比较腔体剃除术与肿瘤切除术的研究。比较研究和自我对照研究都包括在内。使用随机效应模型来估计阳性切缘率、再手术率、复发率和切除组织体积的加权平均差（WMD）的比值比（OR）。荟萃分析中纳入了 26 项研究。空腔剃除组的阳性切缘率显着低于单独 BCS 组（16.4% vs. 31.9%；OR = 0.41，95% CI 0.32–0.53，P < 0.05）。腔体剃除与显着降低的再手术率相关（OR = 0.42，95% CI 0.30-0.59，P < 0.05）。腔体剃除和单独使用 BCS 的总体局部率较低（3% 与 4%）。腔体剃除对局部复发风险没有显着影响（OR = 0.86，95% CI 0.32–2.35；P = 0.78）。腔体剃除和单独 BCS 之间切除的组织体积没有显着差异（WMD = -23.88，95% CI -55.20 至 7.44，P = 0.14）。对于接受BCS的患者，额外的腔体剃除是降低切缘阳性率、避免再次手术的有效方法。与单独的部分乳房切除术相比，增加空腔剃除术似乎没有切除过多的组织体积。
The margin status is a well-established prognostic predictor for patients undergoing breast-conserving surgery (BCS). Recent data suggested that cavity shaving in addition to lumpectomy might be a promising approach for improving the clinical outcomes. We aimed to compare the efficacy and safety between cavity shaving plus lumpectomy and lumpectomy alone with a systematic review and meta-analysis. We searched the PubMed, Embase, and Cochrane CENTRAL databases for studies comparing cavity shaving with lumpectomy before June 10, 2016. Both comparative studies and self-control studies were included. A random-effects model was used to estimate the odds ratios (ORs) for positive margin rate, reoperation rate, recurrence rate, and weighted mean difference (WMD) for excised tissue volume. Twenty-six studies were included in the meta-analysis. The cavity shaving group had a significantly lower positive margin rate than the BCS-alone group (16.4% vs. 31.9%; OR = 0.41, 95% CI 0.32–0.53, P < 0.05). Cavity shaving was associated with a significantly decreased rate of reoperation (OR = 0.42, 95% CI 0.30–0.59, P < 0.05). The overall locoregional rate was low for cavity shaving and BCS-alone (3% vs. 4%). Cavity shaving had no significant effect on the risk of locoregional recurrence (OR = 0.86, 95% CI 0.32–2.35; P = 0.78). The excised tissue volume did not differ substantially between cavity shaving and BCS alone (WMD = −23.88, 95% CI −55.20 to 7.44, P = 0.14). For patients undergoing BCS, additional cavity shaving was an effective method to decrease the positive margin rate and avoid reoperation. The addition of cavity shaving did not appear to have excessive excised tissue volume compared with partial mastectomy alone.
登录
查看更多内容
影响因子：
3.8
作者：
Keskek, M;Kothari, M;Gui, GPH
通讯作者：
Gui, GPH
DOI：
10.1056/nejmoa1504473
发表时间：
2015-08-06
期刊：
The New England journal of medicine
影响因子：
--
作者：
Chagpar AB;Killelea BK;Tsangaris TN;Butler M;Stavris K;Li F;Yao X;Bossuyt V;Harigopal M;Lannin DR;Pusztai L;Horowitz NR
通讯作者：
Horowitz NR
影响因子：
9
作者：
Akashi-Tanaka, S;Fukutomi, T;Hasegawa, T
通讯作者：
Hasegawa, T
影响因子：
3.7
作者：
Hequet, Delphine;Bricou, Alexandre;Barranger, Emmanuel
通讯作者：
Barranger, Emmanuel
影响因子：
5.6
作者：
Cao, DF;Lin, C;Argani, P
通讯作者：
Argani, P