'PartBreCon' study. A UK multicentre retrospective cohort study to assess outcomes following PARTial BREast reCONstruction with chest wall perforator flaps

被引：18

作者：

Agrawal, A. ^{[1
]}

Romics, L. ^{[2
]}

Thekkinkattil, D. ^{[3
]}

Soliman, M. ^{[1
,4
]}

Kaushik, M. ^{[5
]}

Barmpounakis, P. ^{[6
]}

Mortimer, C. ^{[7
]}

Courtney, C. A. ^{[8
]}

Goyal, A. ^{[8
]}

Garreffa, E. ^{[8
]}

Carmichael, A. ^{[9
]}

Lane, R. A.

Rutherford, C. ^{[10
]}

Kim, B. ^{[11
]}

Achuthan, R. ^{[11
]}

Pistinis, V. ^{[12
]}

Goh, S. ^{[13
]}

Ray, B. ^{[14
]}

Grover, K. ^{[15
]}

Vidya, R. ^{[16
]}

Murphy, J. ^{[17
]}

机构：

[1] Cambridge Univ Hosp, Cambridge, England

[2] New Victoria Hosp, Glasgow, Scotland

[3] Lincoln Cty Hosp, Lincoln, England

[4] Mansoura Univ, Mansoura, Egypt

[5] Univ Hosp Leicester NHS Trust, Leicester, England

[6] Athens Univ Econ & Business, Dept Stat, Athens, Greece

[7] Ipswich Hosp, Ipswich, England

[8] Royal Derby Hosp, Derby, England

[9] Univ Hosp Derby & Burton, Belvedere Rd, Burton Upon Trent, England

[10] Gartnavel Royal Hosp, Glasgow, Scotland

[11] St James Univ Hosp, Leeds, England

[12] Ninewells Hosp, Dundee, Scotland

[13] Peterborough Hosp, Peterborough, England

[14] Harrogate NHS Trust, Harrogate, England

[15] Hull Royal Infirm, Kingston Upon Hull, England

[16] Royal Wolverhampton NHS Trust, Wolverhampton, England

[17] Manchester Univ Hosp, Manchester, England

[18] PartBreCon Collaborators, Kingston Upon Hull, England

来源：

BREAST | 2023年 / 71卷

关键词：

Oncoplastic breast surgery; Partial breast reconstruction; Chest wall perforator flap; LICAP; LTAP; TDAP; CONSERVING SURGERY; TUMOR BED; CANCER; CLASSIFICATION; CONSERVATION; MASTECTOMY; GUIDELINES; EXPERIENCE; WOMEN; BOOST;

D O I：

10.1016/j.breast.2023.07.007

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Partial breast reconstruction with a pedicled chest wall perforator flap (CWPF) enables breast conservation in a higher tumour: breast volume ratio scenario. Since there is limited evidence, this retrospective cohort study aimed to ascertain immediate (30-days) and medium-term (follow-up duration) surgical outcomes. Methods: STROBE-compliant protocol ascertained CWPF outcomes between March 2011-March 2021. UK centres known to perform CWPF were invited to participate if they performed at least 10 cases. Data were retrospectively collected, including patient demographics, tumour and treatment characteristics, and surgical and oncological outcomes. Statistical analysis (RTM) included multivariable logistic regression and sensitivity analysis. Results: Across 15 centres, 507 patients with median age (54 years, IQR; 48-62), body mass index (25.4 kg/m2, IQR; 22.5-29), tumour size (26 mm, IQR; 18-35), and specimen weight (62 g, IQR; 40-92) had following flap types: LiCAP (54.1%, n = 273), MiCAP/AiCAP (19.6%, n = 99), LiCAP + LTAP (19.8%, n = 100) and TDAP (2.2%, n = 11). 30-days complication rates were in 12%: haematoma (4.3%, n = 22), wound infection (4.3%, n = 22), delayed wound healing (2.8%, n = 14) and flap loss (0.6%, n = 3; 1 full) leading to readmissions (2.6%, n = 13) and re-operations (2.6%, n = 13). Positive margins (n = 88, 17.7%) led to 15.9% (n = 79) re-excisions, including 7.5% (n = 37) at the planned 2nd of 2-stage surgery and 1.8% (n = 9) mastectomy. At median 23 months (IQR; 11-39) follow-up, there were 1.2% (n = 6) symmetrisations; recurrences: local (1%), regional/ nodal (0.6%) and distant (3.2%). Conclusions: This large multicentre cohort study demonstrates acceptable complication and margin re-excision rates. CWPF extends the range of breast conservation techniques. Further studies are required for long-term oncological outcomes.

引用

页码：82 / 88

页数：7

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