Comparing long-term prognosis following different surgical methods in patients with early stage breast cancer and obesity: a retrospective cohort study in China.

Autor:	Li L; Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.; Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.; Clinical Research Center for Breast Disease in Hunan Province, Changsha, China., Pang J; Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.; Clinical Research Center for Breast Disease in Hunan Province, Changsha, China., Yan Y; Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China.; Clinical Research Center for Breast Disease in Hunan Province, Changsha, China., Zhang Q; Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China., Zheng S; Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China., Chen M; Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China., Yi W; Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, China wujiong1122@vip.sina.com yiwenjun@csu.edu.cn.; Clinical Research Center for Breast Disease in Hunan Province, Changsha, China., Wu J; Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China wujiong1122@vip.sina.com yiwenjun@csu.edu.cn.; Collaborative Innovation Center for Cancer Medicine, Shanghai, China.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Aug 30; Vol. 14 (8), pp. e078816. Date of Electronic Publication: 2024 Aug 30.
DOI:	10.1136/bmjopen-2023-078816
Abstrakt:	Objective: Breast-conserving therapy (BCT) includes breast-conserving surgery (BCS) combined with radiation therapy (RT). RT plays a crucial role in improving the prognosis of patients who undergo BCS. However, obesity is a potential risk factor for resistance to radiation. The aim of this study was to evaluate any difference in the long-term prognosis of patients with early stage breast cancer and obesity treated with BCT or total mastectomy (TM). Design, Setting and Participants: This was a retrospective cohort study involving 1125 patients diagnosed with early stage breast cancer and obesity at the Shanghai Cancer Center of Fudan University from 2013 to 2016. Outcome Measures: Obesity in the Chinese population was defined as a body mass index ≥28 kg/m 2 . Surgical options included BCT and TM. The primary survival outcomes were overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS). Inverse probability of treatment weighting (IPTW) was used to control for the impact of confounding factors on prognosis. Results: The median follow-up times in the BCT group and TM group without postoperative RT were 51.1 months (IQR of 40.6-68.1 months) and 61.8 months (IQR of 46.5-76.7 months), respectively. After IPTW, the baseline data were balanced. Compared with those in the TM cohort, patients in the whole IPTW cohort in the BCT cohort had worse DFS (HR 4.280, 95% CI 2.180 to 8.400; p<0.001), RFS (HR 4.380, 95% CI 2.370 to 8.120; p<0.001) and OS (HR 3.590, 95% CI 1.620 to 7.950; p=0.002). Conclusion: In patients with early stage breast cancer and obesity, TM is associated with better survival outcomes than BCT. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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