Short term safety of oncoplastic breast conserving surgery for larger tumors
Short term safety of oncoplastic breast conserving surgery for larger tumors
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DOI：
10.1016/j.ejso.2016.11.021
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发表时间：
2017-04-01
期刊：
影响因子：
3.8
通讯作者：
Strobbe, L. J. A.
中科院分区：
文献类型：
--
作者：
Wijgman, D. J.;ten Wolde, B.;Strobbe, L. J. A.
背景：肿瘤整形外科(OPS)取代肿块切除术成为保乳手术(BCS)的标准技术。OPS已显示出良好的美容效果，但它与标准的肿块切除术一样安全吗？我们进行了一项回顾性队列研究，以确定与标准肿瘤切除术相比，OPS的术后并发症、切除范围和再次切除率。方法：根据荷兰癌症登记中心的数据和医疗记录，我们对患者、治疗和随访相关变量进行评分。所有在2010年1月至2014年12月期间在一家专门的乳房中心接受保乳手术的连续患者都符合条件。乳房外科医生进行了手术。包括侵袭性肿瘤和原位肿瘤。术后30天内的并发症和需要额外治疗的情况按Clavien Dindo分类进行分类。结果：我们纳入了828名女性842名乳腺癌患者，她们接受了标准的肿块切除术(62.7%)或肿瘤切除(37.3%)。对于较大的肿瘤(17.5mmvs13.6 mm，p=0.002)和位于乳房尾侧的肿瘤(33.1%vs16.9%，p<；0.001)，OPS手术的频率更高。两组术后并发症发生率差异无统计学意义。阳性手术切缘相似(OPS 22.6%，肿块切除18.2%，P=0.119)，再切除率也相似(P=0.337)。结论：肿瘤性乳房整形手术可以安全地应用于较大的肿瘤，其术后并发症、切缘和再次切除率与标准肿块切除相当。(C)2016爱思唯尔有限公司、类似于癌症外科协会的BASO和欧洲外科肿瘤学学会。版权所有。
Background: Oncoplastic surgery (OPS) replaces lumpectomy as standard technique in breast conserving surgery (BCS). OPS has shown to give good cosmetic results, but is it as safe as standaid lumpectomy? We conducted a retrospective cohort study to determine postoperative complications, resection margins and re-excision rates for OPS compared to standard lumpectomy.Methods: Based on data from the 'Netherlands Cancer Registry' and medical records we scored patient, treatment and follow-up related variables. All consecutive patients, with an initially breast conserving operation for primary breast cancer, performed between January 2010 and December 2014 in a dedicated breast center were eligible. Breast surgeons performed the operations. Invasive and in situ tumors were included. Postoperative complications within 30 days after surgery and the need for additional treatment were classified using the Clavien Dindo classification. Involved margin rates and subsequent re-excision were compared.Results: We included 828 women with 842 breast cancers, who had a standard lumpectomy (62.7%) or oncoplastic resection (37.3%). OPS was performed more often for larger tumors (17.5 mm vs 13.6 mm, p = 0.002) and for tumors in the caudal half of the breast (33.1% vs 16.9%, p < 0.001). There was no significant difference in postoperative complications. Positive surgical margins were similar (OPS 22.6%, lumpectomy 18.2%, p = 0.119), as were re-excision rates (p = 0.337).Conclusion: Oncoplastic breast surgery can be safely applied in larger tumors, resulting in comparable postoperative complications, resection margins and re-excision rates compared to standard lumpectomy. (C) 2016 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.