Does neoadjuvant chemotherapy affect morbidity, mortality, reoperations, or readmissions in patients undergoing lumpectomy or mastectomy for breast cancer?
| Autor: | Barbara Bennie, Jeffrey Landercasper, Choua A Vang, Jared H. Linebarger, Mallory S Bray |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Chemotherapy
medicine.medical_specialty business.industry medicine.medical_treatment Lumpectomy Confounding 030230 surgery medicine.disease Logistic regression Confidence interval Surgery 03 medical and health sciences 0302 clinical medicine Breast cancer 030220 oncology & carcinogenesis medicine Original Article business Neoadjuvant therapy Mastectomy |
| Zdroj: | Gland Surgery. 6:14-26 |
| ISSN: | 2227-8575 2227-684X |
| DOI: | 10.21037/gs.2016.08.04 |
| Popis: | Background: The influence of neoadjuvant chemotherapy (NAC) prior to breast cancer surgery on postoperative complications is unclear. Our objective was to determine whether NAC was associated with postoperative outcomes in patients undergoing lumpectomy or mastectomy without reconstruction. Methods: Patients meeting inclusion criteria were identified from the National Surgical Quality Improvement Program (NSQIP) database participant user files from 2005 through 2012, after which NSQIP discontinued the NAC variable. Primary outcome measures included a composite measure of morbidity and mortality (M&M) and reoperations and readmissions within 30 days of the index procedure. Rates of postoperative complications stratified by receipt of NAC were compared by χ 2 . A logistic regression model was then built that included confounding factors for M&M. Results: There were 30,309 patients meeting inclusion criteria. NAC was not associated with any postoperative outcomes from 2005 through 2012, but it was associated with higher MM 95% confidence interval (CI), 1.239–5.368]. Conclusions: The finding that NAC was associated with higher M&M in lumpectomy patients during 2011 to 2012 warrants further investigation. Therefore, we recommend that the NSQIP database reinstitute the NAC variable to allow monitoring during anticipated changes in chemotherapy agents and protocols. |
| Databáze: | OpenAIRE |
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