The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres

被引：8

作者：

Emanuele Lisa, Andrea Vittorio ^{[1
]}

Salgarello, Marzia ^{[2
]}

Huscher, Alessandra ^{[3
]}

Corsi, Fabio ^{[4
,5
]}

Piovani, Daniele ^{[6
,7
]}

Rubbino, Federica ^{[8
]}

Andreoletti, Stefania ^{[1
]}

Papa, Giovanni ^{[9
]}

Klinger, Francesco ^{[10
]}

Tinterri, Corrado ^{[11
]}

Testori, Alberto ^{[11
]}

Scorsetti, Marta ^{[12
]}

Veronesi, Paolo ^{[13
]}

Leonardi, Maria Cristina ^{[14
]}

Rietjens, Mario ^{[15
]}

Cortinovis, Umberto ^{[16
]}

Summo, Valeria ^{[17
]}

Rampino Cordaro, Emanuele ^{[17
]}

Parodi, Pier Camillo ^{[18
]}

Persichetti, Paolo ^{[18
]}

Barone, Mauro ^{[19
]}

De Santis, Giorgio ^{[19
]}

Murolo, Matteo ^{[20
]}

Riccio, Michele ^{[20
]}

Aquinati, Angelica ^{[21
,22
]}

Cavaliere, Francesco ^{[21
,22
]}

Vaia, Nicola

Pagura, Giulia

Dalla Venezia, Erica

Bassetto, Franco

Vindigni, Vincenzo ^{[23
]}

Ciuffreda, Luigi ^{[23
]}

Bocchiotti, Maria Alessandra

Sciarillo, Alberto

Renzi, Nadia

Meneghini, Graziano

Kraljic, Tajna

Loreti, Andrea

Fortunato, Lucio ^{[24
]}

Pino, Valentina

Vinci, Valeriano ^{[6
,7
]}

Klinger, Marco ^{[1
]}

机构：

[1] Univ Milan, IRCCS Humanitas Res Hosp, Reconstruct & Aesthet Plast Surg Sch, Dept Med Biotechnol & Translat Med BIOMETRA,Plast, Milan, Italy

[2] Univ Cattolica Sacro Cuore, IRCCS Policlin Gemelli, Dept Plast Surg, Residency Program Plast Surg, Rome, Italy

[3] Fdn Poliambulanza Guido Berlucchi Hosp, Dept Radiotherapy, Brescia, Italy

[4] IRCCS Ist Clin Maugeri, Dept Surg, Breast Unit, Pavia, Italy

[5] Univ Milan, Dept Biomed & Clin Sci, Milan, Italy

[6] IRCCS Humanitas Univ, Dept Biomed Sci, Milan, Italy

[7] IRCCS Humanitas Res Hosp, Milan, Italy

[8] IRCCS Humanitas Res Hosp, Lab Mol Gastroenterol, Milan, Italy

[9] Univ Trieste, Dept Plast Surg, UCO, Trieste, Italy

[10] IRCCS Multimed, Milan, Italy

[11] IRCCS Humanitas Res Hosp, Breast Unit, Milan, Italy

[12] IRCCS Humanitas Res Hosp, Radiotherapy & Radiosurg Dept, Milan, Italy

[13] Univ Milan, IRCCS European Inst Oncol, Dept Oncol & Oncohematol, Div Senol,IEO, Milan, Italy

[14] IRCCS European Inst Oncol, Div Radiotherapy, IEO, Milan, Italy

[15] IRCCS European Inst Oncol, Div Plast & Reconstruct Surg, IEO, Milan, Italy

[16] IRCCS Natl Canc Inst, Dept Plast Reconstruct Surg, Milan, Italy

[17] Santa Maria Misericordia Hosp, Azienda Sanit Univ Friuli Cent ASUFC, Dept Plast Surg, Udine, Italy

[18] Univ Rome, Campus Biomed, Rome, Italy

[19] Univ Modena & Reggio Emilia, Dept Plast Surg, Policlin Modena, Modena, Italy

[20] Azienda Osped Univ Osped Riuniti, Dept Reconstruct Surg & Hand Surg, Ancona, Italy

[21] Belcolle Hosp, Dept Breast Surg, Viterbo, Italy

[22] Belcolle Hosp, Integrated Senol Ctr, Viterbo, Italy

[23] Casa Sollievo Sofferenza Hosp, Breast Unit, Foggia, Italy

[24] San Giovanni Addolorata Hosp, Breast Unit, Rome, Italy

来源：

BREAST JOURNAL | 2023年 / 2023卷

关键词：

POSTMASTECTOMY RADIATION; MASTECTOMY; COMPLICATIONS; SATISFACTION; IMMEDIATE; SURGERY; FAILURE;

D O I：

10.1155/2023/6688466

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose. In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a national multicenter study to analyze the impact of PMRT on breast reconstruction. Methods. We conducted a retrospective case-control multicenter study on women undergoing breast reconstruction. Data were collected from 18 Italian Breast Centres and stored in a cumulative database which included the following: autologous reconstruction, direct-to-implant (DTI), and tissue expander/immediate (TE/I). For all patients, we described complications and surgical endpoints to complications such as reconstruction failure, explant, change in type of reconstruction, and reintervention. Results. From 2001 to April 2020, 3116 patients were evaluated. The risk for any complication was significantly increased in patients receiving PMRT (aOR, 1.73; 95% CI, 1.33-2.24; p<0.001). PMRT was associated with a significant increase in the risk of capsular contracture in the DTI and TE/I groups (aOR, 2.24; 95% CI, 1.57-3.20; p<0.001). Comparing type of procedures, the risk of failure (aOR, 1.82; 95% CI, 1.06-3.12, p=0.030), explant (aOR, 3.34; 95% CI, 3.85-7.83, p<0.001), and severe complications (aOR, 2.54; 95% CI, 1.88-3.43, p<0.001) were significantly higher in the group undergoing DTI reconstruction as compared to TE/I reconstruction. Conclusion. Our study confirms that autologous reconstruction is the procedure least impacted by PMRT, while DTI appears to be the most impacted by PMRT, when compared with TE/I which shows a lower rate of explant and reconstruction failure. The trial is registered with , and the date of registration is 1 March, 2021, retrospectively registered.

引用

页数：11

共 39 条

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[2] Delayed two-stage breast reconstruction: The impact of radiotherapy
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[3] Optimal timing of postmastectomy radiotherapy in two-stage prosthetic breast reconstruction: An updated meta-analysis
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[4] Two-Stage Prosthetic Breast Reconstruction Using AlloDerm Including Outcomes of Different Timings of Radiotherapy
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[9] Two-stage prosthetic breast reconstruction with latissimus flap: Prepectoral versus subpectoral approach
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[10] Comparing Cortiva Silhouette to AlloDerm for Use in Prepectoral Two-stage Prosthetic Breast Reconstruction
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