The relationship between time to surgery(TTS) after neoadjuvant chemotherapy (NAC)and survival in breast cancer patients: meta-analysis
Abstract PURPOSE: This meta-analysis aims to evaluate the impact of delaying surgery in operable breast tumor patients after neoadjuvant chemotherapy (NAC) on survival.METHODS: An electronic literature retrieval was conducted on PubMed/Medline and EMBASE((between January 2000 and June 2020).The primary end point was overall survival(OS),secondary end points included disease-free survival (DFS) or recurrence-free survival (RFS).The HR with 95% confidence intervals were calculated using a random-effects or fixed-effects model.RESULTS: The combined HR for OS was 1.52(95% CI 1.29-1.78; P = 0.000) by fixed-effects model.No statistically significant heterogeneity was found (P=0.114;I2=39.8%).The pooled HR for RFS/DFS was 1.47 (95%CI: 1.27- 1.71,I2=61.9%) by random-effects model, with significant heterogeneity.CONCLUSION: Our meta-analysis revealed a significant adverse association between longer TTS after NAC and more inferior OS and RFS/DFS in patients with breast cancer.Clinicians and patients should minimize surgical delay after NAC as much as possible.