The impact of immediate lipofilling on oncological outcomes, complication rates and patient reported outcomes in breast conserving surgery: a systematic review and meta-analysis

IF 2.9 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-09-13 DOI:10.1016/j.ejso.2025.110446

James Lucocq , Hassan Baig , J. Michael Dixon

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引用次数: 0

Abstract

Background

There is concern from in-vitro studies that adipose-derived stem cells could promote cancer recurrence through their proliferative properties. The impact of immediate lipofilling (ILF) in the setting of breast conserving surgery (BCS) on oncological outcomes, complications and patient-reported outcomes are unknown.

Methods

A systematic search of Medline, Embase and Cochrane Central was conducted for studies investigating the impact of ILF in patients undergoing BCS. Random-effects meta-analysis were conducted for oncological outcomes (local [LR], regional [RR], distant [DR] and overall recurrence).

Results

Six studies fulfilled the inclusion criteria including 252 patients. The pooled LR, RR, DR and overall recurrence rates were 2.38 %, 1.52 %, 3.03 % and 5.95 %, respectively (median follow-up, 39 months). A meta-analysis of studies comparing ILF (n = 170) with no-ILF (n = 362) found no difference in LR (OR, 0.77; 95 % CI, 0.19–3.17; p = 0.714), RR (OR 1.73, 95 % CI 0.36–8.21, p = 0.686), DR (OR 1.37, 95 % CI, 0.51–3.63; p = 0.627) or overall recurrence (OR 1.23, 95 % CI, 0.60–2.52; p = 0.569). Cancer-specific survival in the ILF group was 100 % compared to 98.7 % with no-ILF. Post-operative calcifications (12.9 % [21/163] vs. 0 %; [0/72], p = 0.002) and fat necrosis (7.8 % (17/217] vs. 2.8 % [8/283], p = 0.011) were significantly more common with ILF, but early complications (e.g. haematoma and infection) showed no difference (p > 0.05). Three studies reported superior Breast-Q scores in ILF compared to no-ILF. No randomised controlled trials have been conducted.

Conclusion

Immediate lipofilling following BCS appears oncologically safe, enhances aesthetic outcomes and causes minimal morbidity, but higher-quality studies are required.

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保乳手术中立即充脂对肿瘤预后、并发症发生率和患者报告结果的影响：一项系统回顾和荟萃分析

背景：体外研究表明，脂肪来源的干细胞可能通过其增殖特性促进癌症复发。保乳手术（BCS）中立即充脂（ILF）对肿瘤预后、并发症和患者报告结果的影响尚不清楚。方法：系统检索Medline、Embase和Cochrane Central，研究ILF对BCS患者的影响。对肿瘤预后（局部[LR]、区域[RR]、远处[DR]和总体复发）进行随机效应荟萃分析。结果：6项研究包括252例患者符合纳入标准。合并LR、RR、DR和总复发率分别为2.38%、1.52%、3.03%和5.95%（中位随访39个月）。一项比较ILF （n = 170）和非ILF （n = 362）研究的荟萃分析发现，LR （OR, 0.77; 95% CI, 0.19-3.17; p = 0.714）、RR （OR 1.73, 95% CI 0.36-8.21, p = 0.686）、DR （OR 1.37, 95% CI, 0.51-3.63; p = 0.627）和总复发率（OR 1.23, 95% CI, 0.60-2.52; p = 0.569）没有差异。ILF组的癌症特异性生存率为100%，而非ILF组为98.7%。术后钙化（12.9% [21/163]vs. 0%; [0/72], p = 0.002）和脂肪坏死(7.8% （17/217]vs. 2.8% [8/283], p = 0.011）在ILF中更为常见，但早期并发症（如血肿、感染）无显著差异（p < 0.05）。三项研究报告了与非ILF相比，ILF患者的Breast-Q评分更高。没有进行随机对照试验。结论：BCS术后立即脂质填充在肿瘤学上是安全的，可以提高美观效果，并且导致最小的发病率，但需要更高质量的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.