The influence of neoadjuvant chemotherapy on complications of immediate DIEP flap breast reconstructions

Autor: Jop Beugels, R.R.W.J. van der Hulst, Stefania Tuinder, Andrzej Piatkowski, J. L. W. Meijvogel, Vivianne C. G. Tjan-Heijnen, Esther M. Heuts
Přispěvatelé: Plastische Chirurgie (PLC), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA AIOS Neurochirurgie (9), MUMC+: MA AIOS Plastische Chirurgie (9), MUMC+: MA Plastische Chirurgie (9), Interne Geneeskunde, MUMC+: MA Medische Oncologie (9), Surgery, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, MUMC+: MA Plastische Chirurgie (3), MUMC+: CONC Poli Plast Chirurgie (9)
Rok vydání: 2019
Předmět:
Zdroj: Breast Cancer Research and Treatment
Breast Cancer Research and Treatment, 176(2), 367-375. Springer, Cham
ISSN: 1573-7217
0167-6806
Popis: Purpose The impact of neoadjuvant chemotherapy on the surgical outcomes of immediate breast reconstruction remains controversial. The aim of this study was to analyze the incidence of complications of immediate deep inferior epigastric artery perforator (DIEP) flap breast reconstructions in patients who received neoadjuvant chemotherapy compared to patients without neoadjuvant chemotherapy prior to surgery. Methods A multicenter, retrospective cohort study was conducted of all patients who underwent immediate DIEP flap breast reconstruction between January 2010 and June 2017. Patients were divided in two groups as breast reconstructions with or without neoadjuvant chemotherapy, respectively. The primary outcome was the incidence of postoperative flap re-explorations, recipient-site complications and donor-site complications. Results In total 432 immediate DIEP flap breast reconstructions in 326 patients were included. Forty-eight patients (n = 67 flaps) received neoadjuvant chemotherapy prior to immediate breast reconstruction and 278 patients (n = 365 flaps) did not. No statistically significant differences for any major (4.5% vs. 10.4%; p = 0.175) or minor (16.4% vs. 24.7%; p = 0.191) recipient-site complication were observed. Donor-site complications were recorded in 9 (18.8%) and 62 (22.2%) patients, respectively (p = 0.587). There was no difference in need for flap re-exploration between groups (3.0% vs. 8.5%; p = 0.139). Correction for potential confounding variables did not result in significant differences. Conclusions This study demonstrated similar complication rates for patients with and without neoadjuvant chemotherapy prior to immediate breast reconstruction, indicating that it is safe to perform an immediate DIEP flap breast reconstruction after neoadjuvant chemotherapy. Electronic supplementary material The online version of this article (10.1007/s10549-019-05241-9) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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