Oncological Outcomes and Complications After Volume Replacement Oncoplastic Breast Conservations-The Glasgow Experience.
Oncological Outcomes and Complications After Volume Replacement Oncoplastic Breast Conservations-The Glasgow Experience.
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DOI：
10.4137/bcbcr.s41017
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Romics L
中科院分区：
文献类型：
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作者：
Ho W;Stallard S;Doughty J;Mallon E;Romics L
肿瘤整形保乳手术（OBCS）结合了肿瘤外科和整形外科的原理。 OBCS 现在已成为乳腺癌治疗的越来越多的选择，并成为保乳疗法 (BCT) 的一部分。我们试图调查并报告我们在格拉斯哥的两个乳腺科（维多利亚医院和西部医院）进行体积置换 OBCS 的经验。从 2010 年 11 月至 2015 年 10 月的前瞻性记录数据库中确定了接受容量替代 OBCS 治疗的患者的详细信息。对肿瘤塑料数据集中包含的临床记录进行了人口统计、肿瘤、治疗特征和复发的分析。对数据进行随访分析，以确定截至 2016 年 4 月的复发模式和时间。本研究的主要结果是无瘤切缘切除率，次要结果是局部和远处复发率，因为这些与体积替代肿瘤整形乳腺手术 (OPBS) 的整体肿瘤学安全性相关。在此期间，总共进行了 30 例乳房置换手术。前一组的平均年龄为 51 岁。出现症状的患者数量是筛查中发现肿瘤的患者数量的两倍。放射学显示术前肿瘤平均大小为 25.4 毫米。患者接受了 13 个胸腹壁皮瓣、5 个外侧肋间动脉穿支 (LICAP) 皮瓣、2 个胸背动脉穿支 (TDAP) 皮瓣、1 个胸外侧动脉穿支 (LTAP) 皮瓣、1 个新月形皮瓣体积置换手术和 8 次基质旋转。两名患者接受了新辅助化疗。 14 例患者接受了辅助化疗，所有患者均接受了辅助放疗。 22 名患者接受激素治疗，4 名患者接受赫赛汀治疗。不完全切除率为10%。中位随访时间为 48.5 个月。仅检测到一处区域复发。八名患者遇到了某种形式的并发症。这项研究继续表明，体积替代保形术作为乳腺癌患者重建的一种选择具有相对的肿瘤学安全性。迫切需要进一步研究来建立支持长期肿瘤安全性的有力证据。
Oncoplastic breast conservation surgery (OBCS) combines the principles of surgical oncology and plastic surgery. OBCS has now become a growing option for the treatment of breast cancer and forms a part of breast-conserving therapy (BCT). We sought to investigate and report our experience in two breast units in Glasgow (Victoria Infirmary and Western Infirmary) on volume replacement OBCS. Details of patients treated with volume replacement OBCS were identified from a prospectively recorded database from November 2010 to October 2015. The clinical records included in the oncoplastic dataset were analyzed for demographics, tumor, treatment characteristics, and recurrences. The data were analyzed for follow-up to determine the pattern and timing of recurrence up to April 2016. The primary outcome of this study was tumor-free margin resection rates, and the secondary outcomes were locoregional and distant recurrence rates as these correlate with the overall oncological safety of volume replacement oncoplastic breast surgery (OPBS). A total of 30 volume replacement oncoplastic breast conservation procedures have been carried out in this time period. The mean age of the former group was 51 years. Twice as many patients presented symptomatically than had tumors detected on screening. The mean preoperative tumor size on radiology was 25.4 mm. Patients underwent 13 thoracoepigastric flaps, 5 lateral intercostal artery perforator (LICAP) flaps, 2 thoracodorsal artery perforator (TDAP) flaps, 1 lateral thoracic artery perforator (LTAP) flap, 1 crescent flap volume replacement surgery, and 8 matrix rotations. Two patients had neoadjuvant chemotherapy. Fourteen patients had adjuvant chemotherapy, and all patients were treated with adjuvant radiotherapy. Twenty-two patients were treated with hormonal therapy and four patients were treated with Herceptin. The rate of incomplete excision was 10%. Median follow-up time was 48.5 months. Only one regional recurrence was detected. Eight patients encountered some form of complication. This study continues to show the relative oncological safety of volume replacement oncoplastic conservations as an option for reconstruction in breast cancer patients. Further research is urgently needed to build robust evidence supporting the long-term oncological safety.