The impact of autologous breast reconstruction using DIEP flap on the oncologic efficacy of radiation therapy

被引:15
作者
Maalouf, C. [2 ]
Bou-Merhi, J. [3 ]
Karam, E. [4 ]
Patocskai, E. [5 ]
Danino, A. M. [1 ]
机构
[1] Univ Montreal Hosp Ctr CHUM, Notre Dame Hosp, Plast & Reconstruct Surg Dept, 1560 Rue Sherbrooke Est, Montreal, PQ H2L 4M1, Canada
[2] Univ Montreal Hosp Ctr CHUM, Notre Dame Hosp, Dept Plast & Reconstruct, Breast Reconstruct, 1560,Rue Sherbrooke Est, Montreal, PQ, Canada
[3] Univ Montreal Hosp Ctr CHUM, Notre Dame Hosp, Breast Reconstruct Unit, Dept Plast & Reconstruct Surg, 1560 Rue Sherbrooke Est, Montreal, PQ H2L 4M1, Canada
[4] Univ Montreal Hosp Ctr CHUM, Notre Dame Hosp, 1560 Rue Sherbrooke Est, Montreal, PQ H2L 4M1, Canada
[5] Univ Montreal Hosp Ctr CHUM, Notre Dame Hosp, Gen Surg Dept, 1560 Rue Sherbrooke Est, Montreal, PQ H2L 4M1, Canada
来源
ANNALES DE CHIRURGIE PLASTIQUE ESTHETIQUE | 2017年 / 62卷 / 06期
关键词
Breast reconstruction; Radiation therapy; Breast cancer; Tumor recurrence; POSTMASTECTOMY RADIATION; IMMEDIATE RECONSTRUCTION; LOCAL RECURRENCE; RADIOTHERAPY; CANCER; OUTCOMES; SURGERY; COMPLICATIONS; SURVIVAL; VOLUME;
D O I
10.1016/j.anplas.2017.06.001
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction. - In the management of breast cancer radiation therapy plays a substantive role in decreasing local recurrence and increasing overall survival. Still, there exists controversy concerning compromised radiation delivery plans and suboptimal delivery after immediate autologous breast reconstruction. Our study aims to assess the oncologic safety of immediate breast reconstruction (IBR) with a Deep inferior epigastric perforator flap (DIEP), in the setting of adjuvant radiation therapy. Methods. - We conducted a retrospective analysis using a prospectively maintained database of all consecutive women undergoing breast reconstruction with a DIEP flap in the setting of radiation therapy. Independent variables included patient age, cancer stage, tumor grade type and subtype, adjuvant and neoadjuvant chemotherapy, hormonal therapy, diabetes mellitus, and tobacco use. Main outcome variables were: local recurrence, distant metastasis, patient demise and total flap failure. Results. - From July 2008 to January 2014, and out of 450 patients who underwent reconstruction with a DIEP flap, 62 were considered eligible. Thirty patients (48%) had IBR followed by radiation therapy and 32 (52%) had delayed reconstruction preceded by radiation therapy. The two groups were comparable with respect to the independent variables. Local recurrence occurred in 3.2% of patients; 3.3% in the immediate group and 3.1% in the delayed (P = 0.963). Distant metastasis occurred in 6.4% of patients: 10% in the immediate group and 3.1% in the delayed (P = 0.27). Breast cancer related mortality occurred in 4.8%: 6.7% in the immediate group and 3.1% in the delayed (P = 0.52). Conclusion. - Immediate reconstruction with a DIEP flap in the setting of adjuvant radiation therapy is an acceptable approach and appears not to influence the oncologic efficacy of radiation treatment. Further prospective studies are advocated. (C) 2017 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:630 / 636
页数:7
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