scholarly journals Oncologic outcomes after immediate breast reconstruction following mastectomy: comparison of implant and flap using propensity score matching

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jeong Hyun Ha ◽  
Ki Yong Hong ◽  
Han-Byoel Lee ◽  
Hyeong-Gon Moon ◽  
Wonshik Han ◽  
...  
Keyword(s):  
Propensity Score ◽  
Breast Reconstruction ◽  
Propensity Score Matching ◽  
Immediate Breast Reconstruction ◽  
Oncologic Outcomes

Racial Disparity in Immediate Breast Reconstruction; a Gap That is not Closing

2021 ◽  
pp. 229255032110555
Author(s):  
Mahdi Malekpour ◽  
Sean Devitt ◽  
Joseph DeSantis ◽  
Christian Kauffman
Keyword(s):  
Propensity Score ◽  
Breast Reconstruction ◽  
Racial Disparity ◽  
Standard Of Care ◽  
Immediate Breast Reconstruction ◽  
P Value ◽  
National Cancer Database ◽  
Black Females ◽  
Black And White ◽  
Significant Difference

Background: Immediate breast reconstruction (IBR) is offered as part of the standard-of-care to females undergoing mastectomy. Racial disparity in IBR has been previously reported with a longstanding call for its elimination, though unknown if this goal is achieved. The aim of this study was to examine the current association between race and IBR and to investigate whether racial disparity is diminishing. Methods: Data was extracted from the National Cancer Database (NCDB) from 2004 to 2016. All variables in the database were controlled so that the comparison would be made solely between Black and White females. We also analyzed the trend in racial disparity to see if there has been a change from 2004 to 2016 after several calls for healthcare equality. Results: After propensity score matching, 69,084 White females were compared to 69,084 Black females. There was a statistically significant difference between the rate of IBR and race (23,386 [33.9%] in White females vs 20,850 [30.2%] in Black females, P-value  < .001). Despite a twofold increase in the rate of IBR in both White and Black females, a persistent gap of about 4% was observed over the study period, which translates to more than 2,500 Black females not receiving IBR. Conclusions: Using the NCDB database, a racial disparity was identified for IBR between White and Black females from 2004 and 2016. Unfortunately, the gap between the groups remained constant over this 13-year period.

Impact of Blood Transfusion in Free Flap Breast Reconstruction Using Propensity Score Matching

2020 ◽  
Author(s):  
Efstathios Karamanos ◽  
Amita R. Shah ◽  
Julie N. Kim ◽  
Howard T. Wang
Keyword(s):  
Postoperative Complications ◽  
Blood Transfusion ◽  
Propensity Score ◽  
Breast Reconstruction ◽  
Propensity Score Matching ◽  
Free Flap ◽  
Improvement Program ◽  
National Quality ◽  
The Impact ◽  
Perioperative Blood Transfusion

Abstract Background Microvascular thrombosis has been associated with cytokine release and inflammatory syndromes which can occur as a result of blood transfusions. This phenomenon could potentially lead to complications in breast free flap reconstruction. The aim of this study was to evaluate the impact of perioperative blood transfusion in free flap breast reconstruction using large population analysis. Methods The American College of Surgeons National Quality Improvement Program database was queried for delayed free flap breast reconstructions performed in 2016. The study population was divided based on perioperative blood transfusion within 24 hours of the start of the operation. Propensity score matching analysis was used to ensure homogeneity between the two study groups. Primary outcome was unplanned return to the operating room (OR) within 30 days. Secondary outcomes were readmission and complications. Results A total of 1,256 patients were identified. Out of those, 91 patients received a perioperative blood transfusion. All the patients received only one unit of PRBC within the first 24 hours. Those patients were matched with similar patients who did not receive a transfusion on a ratio of 1:3 (273 patients). Patients who received a transfusion had a significantly higher incidence of reoperation (42 vs. 10%, p < 0.001). Patients who received a transfusion were more likely to return to the OR after 48 hours from the initial operation (13 vs. 5%, p = 0.001). All returns to the OR were due to flap-related complications. Perioperative blood transfusion increased the incidence of wound dehiscence (9 vs. 2%, p = 0.041) but had no protective effect on the development of other postoperative complications. Conclusion Perioperative blood transfusion in free flap breast reconstruction is associated with an increased probability of flap-related complications and subsequent return to the OR without decreasing the probability of developing other systemic postoperative complications.

Oncologic outcomes of robotic thyroidectomy: 5-year experience with propensity score matching

2016 ◽  
Vol 30 (11) ◽  
pp. 4785-4792 ◽  
Author(s):  
Kyung Tae ◽  
Chang Myeon Song ◽  
Yong Bae Ji ◽  
Eui Suk Sung ◽  
Jin Hyeok Jeong ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Robotic Thyroidectomy ◽  
Oncologic Outcomes

scholarly journals Oncologic Outcomes of Immediate Breast Reconstruction in Young Women with Breast Cancer Receiving Neoadjuvant Chemotherapy

2021 ◽  
Author(s):  
Zhen-Yu Wu ◽  
Hee Jeong Kim ◽  
Jongwon Lee ◽  
Il Yong Chung ◽  
Jisun Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Breast Reconstruction ◽  
Young Women ◽  
Locoregional Recurrence ◽  
Breast Cancer Mortality ◽  
Young Patients ◽  
Immediate Breast Reconstruction ◽  
Oncologic Outcomes ◽  
Outcome Analysis

Abstract Background: Oncologic safety of postmastectomy breast reconstruction in young women with breast cancer is not well-defined, especially in the setting of neoadjuvant chemotherapy (NACT). We retrospectively compared the oncologic outcomes following nipple-sparing (NSM)/skin-sparing mastectomy (SSM) with immediate breast reconstruction (IBR) and conventional mastectomy (CM) alone in young breast cancer patients after NACT.Methods: A total of 1266 women with primary breast cancer who underwent NACT followed by total mastectomy with or without IBR were reviewed. Of these, only young patients (age ≤40 years at diagnosis) were included in the outcome analysis (n=375). After propensity score-matching by clinical T and N stage, molecular subtype, response to NACT, and adjuvant radiotherapy status, 228 patients were 1:1 matched, comprising balanced IBR group (with NSM/SSM) and CM-alone group. Results: The 5-year locoregional recurrence-free, disease-free, distant metastasis (DM)-free, and breast cancer-specific survival (BCSS) rates for the entire cohort of young patients were 83.4%, 65.3%, 71.7%, and 85.4%, respectively. Locoregional recurrence rates between the matched groups were similar (14% vs. 15.8%; P = 0.710); however, IBR group had significantly lower DM rate (27.2% vs. 40.4%; P = 0.036) and breast cancer mortality (14.9% vs. 27.2%; P = 0.023) than CM-alone group. IBR group showed significantly improved 5-year DM-free survival (74.1% vs. 62.6%; P = 0.043) and BCSS (89.1% vs. 77.6%; P = 0.048) rates than CM-alone group.Conclusions: Our results indicated that IBR with NSM/SSM does not negatively affect long-term oncologic outcomes compared to CM alone in young women with breast cancer receiving NACT.

Oncologic outcomes of radical prostatectomy with neoadjuvant LHRH agonist/estramustine and radiotherapy with neoadjuvant hormonal therapy for high-risk prostate cancer.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 259-259
Author(s):  
Takuya Koie ◽  
Hayato Yamamoto ◽  
Atsushi Imai ◽  
Shingo Hatakeyama ◽  
Takahiro Yoneyama ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Propensity Score ◽  
Neoadjuvant Therapy ◽  
Propensity Score Matching ◽  
Oncologic Outcomes ◽  
Treatment Modalities ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

259 Background: To date, the different treatment modalities for high-risk prostate cancer (Pca) have not been compared in any sufficiently large-scale, prospective, randomized clinical trial. We used propensity-score matching analysis to compare the oncological outcomes of high-risk prostate cancer between patients treated with radical prostatectomy (RP) and those treated with radiation therapy (RT). Methods: We studied 216 patients who received neoadjuvant therapy followed by RP (RP cohort) and 81 patients who received neoadjuvant androgen-deprivation therapy (ADT) followed by RT (RT cohort). The RP cohort received a luteinizing hormone-releasing hormone agonist and estramustine phosphate (280 mg/day) for 6 months prior to RP. The RT cohort received ADT for at least 6 months prior to RT using a 3-dimensional conformal radiotherapy technique. The total radiation dose was 70–76 Gy administered at 2 Gy/fraction. Results: Propensity-score matching identified 78 matched pairs of patients. The 3-year overall survival (OS) rates were 98.3% and 92.1% in the RP and RT groups, respectively (P = 0.156). The 3-year biochemical recurrence-free survival rates were 86.4% and 89.4% in the RP and RT groups, respectively (P = 0.878). Conclusions: Our study findings may suggest almost identical cancer control of RP and RT with appropriate neoadjuvant therapy in high-risk Pca. Therefore, issues of health-related quality of life may have important impact on decision making of treatment in high-risk Pca.

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