Lympho-vascular invasion impacts the prognosis in breast-conserving surgery: a systematic review and meta-analysis

被引:30
作者
Zhong, Yi-Ming [1 ]
Tong, Fei [2 ]
Shen, Jun [3 ]
机构
[1] Zhejiang Univ, Dept Med Oncol, Sir Run Run Shaw Hosp, Med Sch, 3 Rd Qingchun East, Hangzhou, Zhejiang, Peoples R China
[2] Peoples Hosp Longyou Cty, 373 Rongchang Rd, Quzhou, Zhejiang, Peoples R China
[3] Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Surg Oncol, 3 Rd Qingchun East, Zhejiang, Peoples R China
关键词
Breast cancer; Breast-conserving surgery; Lympho-vascular invasion; Prognosis; BLOOD-VESSEL INVASION; SENTINEL-NODE BIOPSY; LOCAL RECURRENCE; CANCER PATIENTS; INDIAN WOMEN; THERAPY; CONSERVATION; MASTECTOMY; RISK; RADIOTHERAPY;
D O I
10.1186/s12885-022-09193-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background It is estimated that breast cancer (BC) incidence, especially that of early-stage breast cancer cases continues to rise due to increased universal screening. Breast-conserving surgery (BCS) is the main intervention for early-stage BC. Lympho-vascular invasion (LVI) is reported to influence breast cancer prognosis but its prognostic value in breast-conserving treatment is controversial. Methods A search was conducted on the Cochrane library, PubMed, Web of Science, and EMBASE from inception to December 1(st), 2021, without language restrictions, to identify studies that explored the prognosis of lympho-vascular invasion in breast-conserving surgery. Reviews of each study were conducted, and data extracted. The meta-analysis was performed with StataSE 16. Study quality assessment was evaluated using the Newcastle-Ottawa Scale. Results Overall, 15 studies with 21,704 patients deemed eligible for this study. Event-free survival (EFS), disease-free survival (DFS), overall survival (OS), distant metastases (DM), loco-regional recurrence (LRR), local recurrence (LR), breast recurrence (BR), disease specific survival (DSS), and breast cancer specific survival (BCSS), were extracted from each study. We found that LVI leads to poor OS (HR = 1.46, 95% CI: 1.17-1.83), DM (HR = 2.08, 95% CI: 1.66-2.60) and LR (HR = 2.00, 95% CI: 1.54-2.61). Conclusions We confirmed that early-stage BC patients with LVI-positive have poorer OS, DFS, LRR, BCSS, DM and LR following receiving BCS than those LVI-negative patients. Mastectomy, in combination with radical systemic therapies could be considered, especially in those requiring second surgery. How to change the impact of LVI on the local recurrence rate and long-term survival in patients who undergo BCS may be a valuable research direction in the future.
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页数:9
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