Impact of neoadjuvant chemotherapy on surgical complications in breast cancer: A systematic review and meta-analysis.
Eur J Surg Oncol
; 48(1): 44-52, 2022 Jan.
Article
em En
| MEDLINE
| ID: mdl-34548216
ABSTRACT
BACKGROUND:
The increased use of neoadjuvant chemotherapy (NACT) facilitates an increase in breast-conserving surgery and immediate breast reconstruction. While NACT is considered to have the same oncological safety as adjuvant chemotherapy, evidence on the impact of NACT on surgical outcomes following breast surgery is unclear and varies across studies. The aim of this systematic review and meta-analysis was to assess the impact of NACT on surgical complications in breast cancer patients undergoing any kind of breast surgery.METHODS:
Database searches were conducted (March 26, 2021) to identify studies assessing the impact of NACT on postoperative complications. Studies were included if they compared a group of patients treated with NACT to a control group that was not, and if they reported at least one of our defined outcomes. Primary effect measures were odds ratios (ORs) and mean difference with a 95% confidence interval. Study quality was assessed by the Newcastle-Ottawa Scale.RESULTS:
Twenty-six studies comprising 134,191 patients were included. NACT was not associated with an increased complication rate for overall complications (OR 1.13, 95% CI 0.86 to 1.47, p = 0.38), individual postoperative complications, nor surgery duration. There was a non-significant trend towards NACT increasing the risk of seroma, wound complications, skin or nipple necrosis, flap ischemia or loss, and implant loss. A significant difference in blood loss was found, favouring NACT (MD = -75.85, 95% CI -107.47 to -44.23, p < 0.00001). Heterogeneity was significant between the studies (I2>50%).CONCLUSION:
Compared to a control group, NACT was not found to affect the surgical complications adversely.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Neoplasias da Mama
/
Mamoplastia
/
Terapia Neoadjuvante
/
Mastectomia
/
Antineoplásicos
Tipo de estudo:
Systematic_reviews
Limite:
Female
/
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article