![]() ![]() ![]() Its pathological effects during an acute and a chronic phase have been well described ( 18), with a maximal loss of endothelial cell and subsequent dermal deleterious changes occurring from months 2 to 6 ( 19). Moreover, this reconstructive technique doesn’t compromise the delivery of PMRT ( 13).Ĭoncerns regarding the outcome of patients with a history of irradiation prior to the reconstruction or PMRT have motivated an important amount of papers during the last years, mainly in the context of Implant-based Immediate Breast Reconstruction ( 9, 14- 17). Immediate breast reconstruction improves patient body self-image and overall psychological well-being when compared with the delayed modality. ( 12) demonstrated an increase in prosthesis-based reconstruction from 27% to 52%, with the subsequent decrease in autologous reconstruction, over the past 10 years. Thus, this reconstructive modality should be considered as a first line option for mastectomy reconstruction.Įven in the setting of the irradiated patient population, Agarwal et al. Different papers had demonstrated its oncological safety ( 10), good satisfaction levels from the cosmetic point of view as well as acceptable long-term outcomes ( 11). During the decade 1998–2008, it was the most common reconstructive option in the States, even ahead of autologous reconstructions ( 8, 9). Two steps prosthesis-based immediate or delayed breast reconstruction remains a regular procedure. Parallel to this, several randomized trials in the field of Radiation Oncology have diminished the threshold for recommending post-mastectomy radiation therapy (PMRT) from four-or-more positive axillary lymph node to the current recommendation (one-to-three), due to its probed capacity to decrease local recurrence and to improve survival rate ( 3- 7). Mastectomies due to breast cancer and as contralateral prophylactic procedures have grown up during the last few years in the United States ( 1, 2). Keywords: Breast reconstruction failure implant meta-analysis radiotherapy Further studies trying to elucidate the influence of the suggested risk factors for RF have to be performed to stablish a consensus about the indications and contraindications of this reconstructive modality. ![]() A funnel plot is performed showing no publication bias exists.Ĭonclusions: There is a tendency towards a higher RF rate when the TTE is irradiated compared with the irradiation of the PI. For the random effect model an OR of 1.85 was obtained (0.96, 3.57 P=0.067). We performed a meta-analysis in two scenarios: a fixed-effect model and a random effect model. Some variables possibly working as risk factors for RF are summarized. Results: Previous meta-analysis are analysed. Secondly, we did a simple literature review in order to identify some variables possibly working as predicting factors for RF. ![]() We selected ten articles (n=1,130) to perform a meta-analysis due to the similarity of their approaches. The time limit applied was from January 2008 to January 2019. The following key words were chosen: Breast Reconstruction AND Implant based AND Immediate. Methods: A systematic search of the literature was performed on PUBMED/MEDLINE. The present article intends to be the biggest cohort meta-analysis to the date comparing reconstructive failure (RF) rate in these two scenarios: PMRT to TE compared with PMRT to PI. When combined with post-mastectomy radiation therapy (PMRT) two different schemas are possible: radiating the temporary tissue expander (TTE) or the permanent implant (PI). Background: Implant-based immediate approach remains to be a first line option for reconstruction of mastectomy defects. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |