A meta-analysis of randomized controlled trials comparing breast-conserving surgery and mastectomy in terms of patient survival rate and quality of life in breast cancer.

Autor:	Li S; Department of Breast Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Key Laboratory of Oncology, Urumqi, Xinjiang 830011, China., Li X; Department of Operating Room, The First People's Hospital of Urumqi Economic and Technological Development Zone, Toutunhe District, Urumqi 830011, Xinjiang, China., Li D; Department of Breast Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Key Laboratory of Oncology, Urumqi, Xinjiang 830011, China., Zhao Q; Department of Breast Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Key Laboratory of Oncology, Urumqi, Xinjiang 830011, China., Zhu L; Department of Breast Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Key Laboratory of Oncology, Urumqi, Xinjiang 830011, China., Wu T; Department of Breast Surgery, The Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang Key Laboratory of Oncology, Urumqi, Xinjiang 830011, China.
Jazyk:	angličtina
Zdroj:	International journal for quality in health care : journal of the International Society for Quality in Health Care [Int J Qual Health Care] 2024 May 30; Vol. 36 (2).
DOI:	10.1093/intqhc/mzae043
Abstrakt:	The study aimed to assess the effects of breast-conserving surgery (BCS) versus mastectomy on survival and quality of life in Stages I, II, and III breast cancer, providing solid evidence for clinical decisions. We conducted a meta-analysis of randomized controlled trials on breast cancer treatments, searching databases such as PubMed and the Cochrane Library to compare BCS, and mastectomy's effects on survival and quality of life. A combined total of 16 734 patients in the control group and 17 435 patients in the experimental group were included in this analysis. This meta-analysis used RevMan 5.3 (Cochrane Collaboration, Copenhagen, Denmark) software for analysis. Our meta-analysis of 34 169 patients from 11 studies showed that BCS significantly reduced the overall recurrence rate at a median follow-up of 29 months, with a mean difference of 1.27 and a 95% confidence interval of 1.19-1.36, strongly supporting its effectiveness (P < .00001). Furthermore, our analysis found no significant increase in 5-year local recurrence rates for BCS versus mastectomy, indicating its long-term effectiveness with a mean difference of 1.13 (95% confidence interval: [1.03, 1.24], P = .01). Additionally, there was a notable decrease in tissue ischaemic necrosis among patients who had received BCS, with a mean difference of 0.37 (95% confidence interval: [0.33, 0.42], P < .00001), underscoring its benefits and long-term viability. BCS resulted in fewer cases of tissue ischaemic necrosis and higher body image scores compared with mastectomy, suggesting that it is a preferable option for better cosmetic outcomes and potentially favourable effects on prognosis and quality of life. (© The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Quality in Health Care.)
Databáze:	MEDLINE
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