Impact Of Neoadjuvant Chemotherapy On Short-and Long-term Outcomes Of Immediate Breast Reconstruction Surgery:A Meta-analysis

Objective:The effect of neoadjuvant chemotherapy on short-and long-term outcomes of immediate breast reconstruction surgery is evaluated by comparing the outcome between neoadjuvant chemotherapy group in which patients operated the immediate breast reconstruction surgery after neoadjuvant chemotherapy and the control group in which patients operated the immediate breast reconstruction surgery only.Methods:A literature search was performed in Pub Med、 Cochrane Library、Embase、CNKI、 Wanfang databases、VIP and CBM from January 2009 to December 2021.Qualified literature related to the effects of neoadjuvant chemotherapy on immediate breast reconstruction was included.Rev Man 5.4 software was used for statistical analysis.Results:A total of 3767 patients from 15 relevant literatures were enrolled in this study,including 827 patients in neoadjuvant chemotherapy group and 2940 patients in control group.Meta-analysis showed that:(1)There were no significant differences between the neoadjuvant chemotherapy group and the control group in postoperative complication、skin necrosis、implant loss 、hematoma、 seroma、 incision infection and fat necrosis.(2)Delay to adjuvant therapy: There was a significant difference between the two groups in delays to adjuvant therapy(OR = 2.52,95%CI :1.23 ~ 5.18,P = 0.01).(3)There were no significant differences in local recurrence rate(OR = 1.20,95%CI :0.47 ~3.04,P = 0.70)、 distant metastasis(OR = 1.75,95%CI :1.00~ 3.04,P = 0.05)rate between the two groups.Conclusion:For breast cancer patients with neoadjuvant chemotherapy,immediate breast reconstruction is operable.Clinicians can perform immediate breast reconstruction surgery for those patients who pursue aesthetic outcomes on the basis of patients’ condition.