Comparison of Oncoplastic Breast-Conserving Surgery and Breast-Conserving Surgery Alone: A Meta-Analysis

被引:47
作者
Chen, Jun-Ying [1 ,2 ,3 ]
Huang, Yi-Jie [4 ]
Zhang, Liu-Lu [5 ]
Yang, Ci-Qiu [5 ]
Wang, Kun [5 ]
机构
[1] Sun Yat Sen Univ, Canc Ctr, Guangzhou, Guangdong, Peoples R China
[2] State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China
[3] Collaborat Innovat Ctr Canc Med, Guangzhou, Guangdong, Peoples R China
[4] Guangdong Acad Med Sci, Guangdong Gen Hosp, Dept Gen Surg, Guangzhou, Guangdong, Peoples R China
[5] Guangdong Acad Med Sci, Guangdong Gen Hosp, Dept Breast Canc, Guangzhou, Guangdong, Peoples R China
关键词
Breast neoplasms; Mammaplasty; Mastectomy; Meta-analysis; 20-YEAR FOLLOW-UP; RE-EXCISION; CANCER PATIENTS; SURGICAL TECHNIQUES; MASTECTOMY; LUMPECTOMY; MARGINS; QUADRANTECTOMY; RESECTION; STANDARD;
D O I
10.4048/jbc.2018.21.e36
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: The use of oncoplastic reconstruction for breast-conserving surgery (BCS) extends benefits beyond merely minimizing poor cosmetic results. However, the feasibility and oncological safety of oncoplastic surgery (OPS) are controversial. Methods: This meta-analysis aimed to compare the short-term and long-term oncological outcomes of BCS alone and BCS plus OPS. Relevant studies published before July 2017 in the Embase, the Cochrane Library, PubMed, and Web of Science databases were screened and collected. The meta-analysis was performed using STATA software (State Corp.). Results: A total of 3,789 patients from 11 studies were included, with 2,691 patients in the BCS-alone group and 1,098 patients in the BCS plus OPS group. The demographics were similar between both groups, and no significant difference was observed in pathological T and N stages between the two groups. Re-excision was less common (relative risk [RR], 0.66; p =0.009) and the positive-margin rate was lower, but not significantly (RR, 0.83; p=0.191), in the BCS plus OPS group than in the BCS-alone group. The local and distal recurrence rates were similar in both groups. Both disease-free survival (hazard ratio [HR], 1.19; 95% confidence interval [CI], 0.96-1.49; p=0.112) and overall survival (HR, 1.14; 95% CI, 0.76-1.69; p=0.527) did not differ between the two groups. Conclusion: A combination of BCS and OPS is preferred over BCS alone for decreasing re-excisions and provides similar long-term survival as BCS alone in patients with breast cancer.
引用
收藏
页码:321 / +
页数:11
相关论文
共 30 条
[1]   Effect of screening and adjuvant therapy on mortality from breast cancer [J].
Berry, DA ;
Cronin, KA ;
Plevritis, SK ;
Fryback, DG ;
Clarke, L ;
Zelen, M ;
Mandelblatt, JS ;
Yakovlev, AY ;
Habbema, JDF ;
Feuer, EJ .
NEW ENGLAND JOURNAL OF MEDICINE, 2005, 353 (17) :1784-1792
[2]   Role of re-excision for positive and close resection margins in patients treated with breast-conserving surgery [J].
Biglia, N. ;
Ponzone, R. ;
Bounous, V. E. ;
Mariani, L. L. ;
Maggiorotto, F. ;
Benevelli, C. ;
Liberale, V. ;
Ottino, M. C. ;
Sismondi, P. .
BREAST, 2014, 23 (06) :870-875
[3]  
Cassi LC, 2016, EUR REV MED PHARMACO, V20, P2950
[4]   How safe is oncoplastic breast conservation?: Comparative analysis with standard breast conserving surgery [J].
Chakravorty, A. ;
Shrestha, A. K. ;
Sanmugalingam, N. ;
Rapisarda, F. ;
Roche, N. ;
della Rovere, G. Querci ;
MacNeill, F. A. .
EJSO, 2012, 38 (05) :395-398
[5]  
Chauhan Ashutosh, 2016, Med J Armed Forces India, V72, P12, DOI 10.1016/j.mjafi.2015.11.001
[6]   Cosmetic sequelae after conservative treatment for breast cancer: Classification and results of surgical correction [J].
Clough, KB ;
Cuminet, J ;
Fitoussi, A ;
Nos, C ;
Mosseri, V .
ANNALS OF PLASTIC SURGERY, 1998, 41 (05) :471-481
[7]   Oncoplastic Surgery: Pushing the Limits of Breast-Conserving Surgery [J].
Clough, Krishna B. ;
Benyahi, Djazia ;
Nos, Claude ;
Charles, Caroline ;
Sarfati, Isabelle .
BREAST JOURNAL, 2015, 21 (02) :140-146
[8]   The role of oncoplastic breast conserving treatment for locally advanced breast tumors. A matching case-control study [J].
da Costa Vieira, Rene Aloisio ;
Angotti Carrara, Guilherme Freire ;
Scapulatempo Neto, Cristovam ;
Morini, Mariana Andozia ;
Brentani, Maria Mitzi ;
Azevedo Koike Folgueira, Maria Aparecida .
ANNALS OF MEDICINE AND SURGERY, 2016, 10 :61-68
[9]   Oncological results of oncoplastic breast-conserving surgery: Long term follow-up of a large series at a single institution: A matched-cohort analysis [J].
De Lorenzi, F. ;
Hubner, G. ;
Rotmensz, N. ;
Bagnardi, V. ;
Loschi, P. ;
Maisonneuve, P. ;
Venturino, M. ;
Orecchia, R. ;
Galimberti, V. ;
Veronesi, P. ;
Rietjens, M. .
EJSO, 2016, 42 (01) :71-77
[10]   Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group [J].
Dowsett, Mitch ;
Nielsen, Torsten O. ;
A'Hern, Roger ;
Bartlett, John ;
Coombes, R. Charles ;
Cuzick, Jack ;
Ellis, Matthew ;
Henry, N. Lynn ;
Hugh, Judith C. ;
Lively, Tracy ;
McShane, Lisa ;
Paik, Soon ;
Penault-Llorca, Frederique ;
Prudkin, Ljudmila ;
Regan, Meredith ;
Salter, Janine ;
Sotiriou, Christos ;
Smith, Ian E. ;
Viale, Giuseppe ;
Zujewski, Jo Anne ;
Hayes, Daniel F. .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2011, 103 (22) :1656-1664