A Systematic Review and Meta-Analysis on the Role of Repeat Breast-Conserving Surgery for the Management of Ipsilateral Breast Cancer Recurrence

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Tollan, Clare JosephineBreast Surgery Unit, The Royal Marsden NHS Foundation Trust, London, UK,Royal Marsden NHS Fdn Trust, Breast Surg Unit, London, England. (författare)

A Systematic Review and Meta-Analysis on the Role of Repeat Breast-Conserving Surgery for the Management of Ipsilateral Breast Cancer Recurrence

Artikel/kapitelEngelska2022

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2022-07-18
Springer,2022
printrdacarrier

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LIBRIS-ID:oai:DiVA.org:oru-100332
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-100332URI
https://doi.org/10.1245/s10434-022-12197-6DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-491211URI

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Språk:engelska
Sammanfattning på:engelska

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Introduction: The standard surgical management of ipsilateral breast cancer recurrence (IBCR) in patients previously treated with breast-conserving surgery (BCS) and radiotherapy (RT) is mastectomy. Recent international guidelines provide conflicting recommendations. The aim of this study was to perform a systematic literature review and meta-analysis of the oncological outcomes in patients with IBCR treated with repeat BCS (rBCS).Methods: The MEDLINE and EMBASE databases were searched for relevant English-language publications, with no date restrictions. All relevant studies providing sufficient data to assess oncological outcomes (second local recurrence [LR] and overall survival [OS]) of rBCS for the management of IBCR after previous BCS and RT were included (PROSPERO registration CRD42021286123).Results: Forty-two observational studies met the criteria and were included in the analysis. The pooled second LR rate after rBCS was 15.7% (95% confidence interval [CI] 12.1-19.7), and 10.3% (95% CI 6.9-14.3) after salvage mastectomy. On meta-analysis of comparative studies (n = 17), the risk ratio (RR) for second LR following rBCS compared with mastectomy was 2.103 (95% CI 1.535-2.883; p < 0.001, I-2 = 55.1%). Repeat RT had a protective effect (coefficient: - 0.317, 95% CI - 0.596 to - 0.038; p = 0.026, I-2 = 40.4%) for second LR. Pooled 5-year OS was 86.8% (95% CI 83.4-90.0) and 79.8% (95% CI 74.7-84.5) for rBCS and salvage mastectomy, respectively. Meta-analysis of comparative studies (n = 20) showed a small OS benefit in favor of rBCS (RR 1.040, 95% CI 1.003-1.079; p = 0.032, I-2 = 70.8%). Overall evidence certainty was very low.Conclusions: This meta-analysis suggests rBCS could be considered as an option for the management of IBCR in patients previously treated with BCS and RT. Shared decision making, appropriate patient selection, and individualized approach are important for optimal outcomes.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng

Biuppslag (personer, institutioner, konferenser, titlar ...)

Pantiora, EiriniUppsala universitet,Endokrinkirurgi(Swepub:uu)eirpa377 (författare)
Valachis, Antonis,1984-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Oncology,Örebro Univ, Fac Med & Hlth, Dept Oncol, Örebro, Sweden.(Swepub:oru)asvs (författare)
Karakatsanis, AndreasUppsala universitet,Endokrinkirurgi(Swepub:uu)andka774 (författare)
Tasoulis, Marios KonstantinosBreast Surgery Unit, The Royal Marsden NHS Foundation Trust, London, UK; Division of Breast Cancer Research, The Institute of Cancer Research, London, UK,Royal Marsden NHS Fdn Trust, Breast Surg Unit, London, England.;Inst Canc Res, Div Breast Canc Res, London, England. (författare)
Breast Surgery Unit, The Royal Marsden NHS Foundation Trust, London, UKRoyal Marsden NHS Fdn Trust, Breast Surg Unit, London, England. (creator_code:org_t)

Sammanhörande titlar

Ingår i:Annals of Surgical Oncology: Springer29:10, s. 6440-64531068-92651534-4681

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Av författaren/redakt...: Tollan, Clare Jo ...; Pantiora, Eirini; Valachis, Antoni ...; Karakatsanis, An ...; Tasoulis, Marios ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

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