Impact of neoadjuvant chemotherapy on surgical complications in breast cancer: A systematic review and meta-analysis

Lorentzen, Tine; Heidemann, Lene Nyhøj; Möller, Sören; Bille, Camilla

doi:10.1016/j.ejso.2021.09.007

Cited by 33 publications

(20 citation statements)

References 62 publications

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“…Post‐operatively, wound dehiscence was reported in 16.7%, which is similar to previously reported risk in treatment naïve MCT 47–49 or following neoadjuvant prednisolone/prednisone 42 . This may suggest that neoadjuvant VBL‐P does not increase the risk of wound complication as reported in humans breast cancer, 50 but further studies would be required to confirm this.…”

Section: Discussionsupporting

confidence: 85%

Pre‐operative neoadjuvant vinblastine‐prednisolone in canine mast cell tumours: A single‐centre retrospective cohort study

Ossowska,

Picornell,

Finotello

et al. 2023

Vet Comparative Oncology

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Neoadjuvant chemotherapy can be used in canine mast cell tumours (MCTs) to optimise surgical margins or to enable marginal excision in challenging locations. The objective of this study was to describe the outcome of dogs with cutaneous and subcutaneous MCTs treated with neoadjuvant vinblastine‐prednisolone (NA‐VP). Records of treatment‐naïve dogs with cutaneous/subcutaneous MCT that received NA‐VP were reviewed including signalment, indication for NA‐VP, staging results, clinical response, surgical data and histopathology reports. For dogs with post‐operative follow‐up ≥365 days, predictive factors for local recurrence (LR) were evaluated. Forty‐four dogs were included. NA‐VP was indicated to optimise surgical margins (group MARG) in 19 dogs (43.2%) and to enable surgery (group MORB) in 25 dogs (56.8%). Complete and partial response were documented in 40.9% of dogs and 30 dogs (68.2%) underwent surgery. The indication for NA‐VP was significantly associated with undergoing surgery (p < .001) on multivariable analysis. Twelve (48%) and 18 dogs (94.7%) underwent surgery in the group MORB and MARG, respectively. Five dogs (16.7%) experienced wound dehiscence. Complete excision was achieved in 14 dogs (46.7%). In dogs undergoing surgery with ≥365 days of follow‐up, LR was documented in five cases (20.8%). None of the factors analysed including mitotic count, completeness of excision and response to NA‐VP were associated with LR; notably, LR occurred in 3/11 (27.2%) completely excised MCTs. In a pre‐operative setting, NA‐VP appears safe and could be beneficial in selected cases. Prognostic factors such as clinical response, mitotic count and completeness of excision should be interpreted with caution following NA‐VP.

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Section: Discussionsupporting

confidence: 85%

Pre‐operative neoadjuvant vinblastine‐prednisolone in canine mast cell tumours: A single‐centre retrospective cohort study

Ossowska,

Picornell,

Finotello

et al. 2023

Vet Comparative Oncology

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“…Furthermore, both chronic pain and impairment of shoulder mobility did however not lead to a delay in adjuvant treatment. [11,23,24] Our results concerning the postoperative complication rate following NST con rm the conclusion of a recently published systematic review and meta-analysis by Lorentzen et al [25] They searched the literature for studies assessing the impact of NST on postoperative complications, comparing a group of patients receiving NST to a control group. According to Lorentzen et al NST is not associated with increased postoperative complications.…”

Section: Discussionsupporting

confidence: 85%

The Impact of Neoadjuvant Systemic Treatment on Postoperative Complications in Breast Cancer Surgery

Maggi

Nussbaumer

Castrezana

et al. 2022

Preprint

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Purpose: The aim of the study was to analyse the impact of neoadjuvant systemic treatment (NST) on postoperative complications and the beginning of adjuvant treatment. Methods: This study includes data from a prospectively maintained database including patients with breast cancer (BC) stage I-IV with or without NST undergoing breast cancer surgery between January 2010 and September 2021. Results: Out of 517 enrolled patients, 77 received NST, 440 had primary breast surgery. After NST patients underwent surgery after a meantime of 34 days (26.5 – 40 days). No statistical significance could be found comparing the complication grading according to the Clavien Dindo classification. The complications were most frequently rated as grade 3b. There were no complications with grade 4 or higher. When differentiating into short and long-term, the overall rate of short-term complications was 20.3% with no significant difference between the two groups (20.8% vs. 20.2%). Regarding long-term complications, there was more impairment of shoulder mobility (26.0% vs. 9.5%, p = < 0.001) and chronic pain (42.9% vs. 28.6%, p = < 0.016) for patients with NST. The beginning of the administration of the adjuvant treatment was comparable in both groups (46.3 days vs. 50.5 days). Conclusion: In our cohort, complications between both groups were comparable according to Clavien Dindo. This study shows that NST has no negative impact on postoperative short-term complications and most importantly did not lead to a delay of the beginning of adjuvant treatment. Therefore, NST can be safely admitted, even when followed by extensive breast reconstruction surgery.

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“…Our results concerning the postoperative complication rate following NST confirm the conclusion of a recently published systematic review and meta-analysis by Lorentzen et al [25] They searched the literature for studies assessing the impact of NST on postoperative complications, comparing a group of patients receiving NST to a control group. According to Lorentzen et al NST is not associated with increased postoperative complications.…”

Section: Overall Short-term and Long-term Complicationssupporting

confidence: 89%

The impact of neoadjuvant systemic treatment on postoperative complications in breast cancer surgery

Nussbaumer

Maggi

Castrezana

et al. 2022

Breast Cancer Res Treat

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Purpose The aim of the study was to analyze the impact of neoadjuvant systemic treatment (NST) on postoperative complications and the beginning of adjuvant treatment. Methods This study includes data from a prospectively maintained database including patients with breast cancer (BC) stage I–IV with or without NST undergoing breast cancer surgery between January 2010 and September 2021. Results Out of 517 enrolled patients, 77 received NST, 440 had primary breast surgery. After NST patients underwent surgery after a meantime of 34 days (26.5–40 days). No statistical significance could be found comparing the complication grading according to the Clavien Dindo classification. The complications were most frequently rated as grade 3b. There were no complications with grade 4 or higher. When differentiating into short and long-term, the overall rate of short-term complications was 20.3% with no significant difference between the two groups (20.8% vs. 20.2%). Regarding long-term complications, there was more impairment of shoulder mobility (26.0% vs. 9.5%, p ≤ 0.001) and chronic pain (42.9% vs. 28.6%, p ≤ 0.016) for patients with NST. The beginning of the administration of the adjuvant treatment was comparable in both groups (46.3 days vs. 50.5 days). Conclusion In our cohort, complications between both groups were comparable according to Clavien Dindo. This study shows that NST has no negative impact on postoperative short-term complications and most importantly did not lead to a delay of the beginning of adjuvant treatment. Therefore, NST can be safely admitted, even when followed by extensive breast reconstruction surgery.

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Impact of neoadjuvant chemotherapy on surgical complications in breast cancer: A systematic review and meta-analysis

Cited by 33 publications

References 62 publications

Pre‐operative neoadjuvant vinblastine‐prednisolone in canine mast cell tumours: A single‐centre retrospective cohort study

Pre‐operative neoadjuvant vinblastine‐prednisolone in canine mast cell tumours: A single‐centre retrospective cohort study

The Impact of Neoadjuvant Systemic Treatment on Postoperative Complications in Breast Cancer Surgery

The impact of neoadjuvant systemic treatment on postoperative complications in breast cancer surgery

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