Local recurrence and residual tumor rates following cryoablation for small early-stage breast cancers: systemic review and meta-analysis.

Autor: Tan E; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore. eelinnn@gmail.com., Chong J; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore., Pua U; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore., Tan EY; Department of Breast and Endocrine Surgery, Tan Tock Seng Hospital, Singapore, Singapore.; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore., Mok WY; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.
Jazyk: angličtina
Zdroj: Breast cancer (Tokyo, Japan) [Breast Cancer] 2024 Oct 19. Date of Electronic Publication: 2024 Oct 19.
DOI: 10.1007/s12282-024-01643-w
Abstrakt: Background: Cryoablation is currently being investigated as a minimally invasive alternative to breast-conserving surgery. This meta-analysis investigates the local recurrence and residual tumor rates after cryoablation for small early-stage breast cancers.
Methods: A systematic search was conducted on Embase, PubMed, Google Scholar, and the International Clinical Trials Registry Platform from inception to 16 June 2024. Studies of patients with breast cancers ≤ 20 mm treated with cryoablation only or cryoablation followed by surgery were included. Pooled local recurrence rates (cryoablation only) and pooled residual tumors rates (cryoablation followed by surgery) were estimated with mixed-effects models. Between-study heterogeneity was assessed using I 2 statistics. Where I 2 exceeded 50%, outlier and influence analysis, followed by sensitivity analysis excluding outliers, were conducted.
Results: Twelve studies met inclusion criteria, of which 7 studies (530 female patients, 531 breast tumors) reported on patients treated with cryoablation only and 5 studies (220 female patients, 222 breast tumors) reported on patients treated with cryoablation followed by surgery. For studies on cryoablation only, pooled local recurrence rate was 1.1% (95% CI 0.42-3.03%) with low between-study heterogeneity (I 2 value = 0%; 95% CI 0.0-70.8%; p = 0.95). For studies on cryoablation followed by surgery, pooled residual tumor rate was 12.0% (95% CI 3.85-31.64%); however, substantial between-study heterogeneity (I 2 value = 76.1%; 95% CI 41.7-90.2%; p < 0.01) was present. Influence analysis revealed 1 outlier study. When this study was excluded, pooled residual tumor rate was 8.2% (95% CI 3.84-16.68%) with improvement in heterogeneity (I 2 value = 0%; 95% CI 0.0-84.7%; p = 0.64).
Conclusion: Pooled local recurrence and residual tumor rates after cryoablation are comparable to local recurrence rates after breast-conserving therapy and re-excision rates following breast-conserving surgery, respectively. These results are encouraging but should be interpreted with caution due to lack of comparative studies.
(© 2024. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.)
Databáze: MEDLINE
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