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IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2025-03-10 DOI:10.1016/j.clbc.2025.03.005

Flávia Cardoso Franca, Idam de Oliveira-Junior, René Aloisio da Costa Vieira

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引用次数: 0

摘要

简介：前胸截肢术（FA）或肩胛胸间离断术适用于浸润性乳腺癌（BC）患者的特定病例：局部晚期或复发肿瘤的初治切除术、Stewart & Treves综合征（STS）或乳腺癌辐射继发肉瘤（辐射诱发肉瘤，RIS）。然而，目前还没有研究对乳腺癌患者进行FA手术的适应症、效果、并发症、复发率和总生存率进行有力的评估：截至 2022 年 12 月 31 日，我们根据 PICOS 和 PRISMA 方法对 8 个数据库进行了系统性回顾。文中提供了描述性统计数字，并生成了 Kaplan-Meier 生存曲线，并用对数秩方法进行了比较：我们确定了 54 篇文章，收集了 100 名患者的数据。48例患者（57.1%）的FA治疗目的是治愈性的，32例（38.1%）是姑息性的。实施手术的原因包括STS（35%）、上肢功能障碍（18%）、淋巴水肿（10%）、复发性腋窝肿瘤（10%）和RIS（9%）。并发症较少。12、24、36和60个月的生存率分别为65.6%、42.8%、36.4%和32.4%。与生存率相关的主要因素是肿瘤情况（P = .05）和手术意图（P < .001；多变量分析）：结论：FA并发症少，并能减轻治愈性和姑息性治疗患者的症状。手术治疗适用于特定病例，如局部晚期肿瘤、腋窝结构浸润、上肢淋巴水肿伴功能丧失、STS 和 RIS，通常是控制局部疾病和改善生活质量的最佳机会。

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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Forequarter Amputation for Breast Cancer. Systematic Review and Survival Analysis.

Introduction: Forequarter amputation (FA) or Interscapulothoracic disarticulation is indicated in patients with invasive breast carcinoma (BC) in selected cases: primary resection of a locally advanced or recurrent tumor, Stewart & Treves syndrome (STS), or sarcoma secondary to radiation due to breast cancer (radiation-induced sarcoma, RIS). However, no studies have robustly evaluated the indications, results, complications, recurrence and overall survival in the context of FA in patients with BC.

Material and methods: We performed a systematic review of 8 databases according to the PICOS and PRISMA methodology through December 31, 2022. Descriptive statistics are presented, and Kaplan‒Meier survival curves were generated and compared with the log-rank method.

Results: We identified 54 articles and collected data from 100 patients. The intention of FA was curative for 48 patients (57.1%) and palliative in 32 (38.1%). The procedure was performed due to STS (35%), upper limb dysfunction (18%), lymphedema (10%), recurrent axillary tumors (10%) and RIS (9%). Complications were low. The survival rates at 12, 24, 36, and 60 months were 65.6%, 42.8%, 36.4%, and 32.4%, respectively. The main factors associated with survival were tumor's condition (P = .05) and surgical intent (P < .001; multivariate analysis).

Conclusion: FA has few complications and attenuates symptoms in patients treated with both curative and palliative intent. Surgery is justified in select cases, such as locally advanced tumors, infiltration of axillary structures, upper limb lymphedema with loss of function, and STS and RIS, and often represents the best chance for local disease control and improvement in quality of life.

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.