Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis
Abstract Background With limited sample sizes and single-institution designs, how complete response (CR) after neoadjuvant chemotherapy (NAC) influences breast conserving surgery (BCS) and its value in prognosis are not clear. Methods A systematic research review was conducted using electronic datab...
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| Format: | Article |
| Language: | English |
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BMC
2017-11-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | http://link.springer.com/article/10.1186/s12957-017-1273-6 |
| _version_ | 1811219336707178496 |
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| author | Xuan Li Danian Dai Bo Chen Hailin Tang Weidong Wei |
| author_facet | Xuan Li Danian Dai Bo Chen Hailin Tang Weidong Wei |
| author_sort | Xuan Li |
| collection | DOAJ |
| description | Abstract Background With limited sample sizes and single-institution designs, how complete response (CR) after neoadjuvant chemotherapy (NAC) influences breast conserving surgery (BCS) and its value in prognosis are not clear. Methods A systematic research review was conducted using electronic database. The rate of clinical complete response (cCR) in BCS after NAC and these pathological CR (PCR) and non-pCR BCS patients’ local recurrence-free survival (LRFS), distance recurrence-free survival (DRFS), overall survival (OS), and disease-free survival (DFS) rates were collected. A pooled analysis was performed using a fixed or random effects model and a Q test to determine heterogeneity. Results Sixteen studies with a total of 4639 patients were included. The pooled data revealed that cCR patients compared with non-cCR patients had significantly higher rates of BCS, with a summary estimate odds ratios (OR) of 4.54 (95% CI 2.03–10.17). The pooled data revealed that BCS patients who achieved pCR after NAC had significantly lower rates of LRFS (RR = 0.59, 95% CI 0.38–0.92) and DRFS (RR = 0.27, 95% CI 0.13–0.55). Better DFS (RR = 0.09, 95% CI 0.04–0.25) and OS (RR = 0.36, 95% CI 0.03–3.90) were also seen, but OS was not significantly different. Conclusions The rate of successful BCS is higher in the cCR group than in the non-cCR group, means cCR after NAC can encourage patients to receive BCS. The achievement of pCR after NAC in BCS patients was associated with a good prognosis in terms of LRFS and DRFS, but its value in DFS and OS requires further investigation. |
| first_indexed | 2024-04-12T07:24:34Z |
| format | Article |
| id | doaj.art-1c1d52dc6fbc4968a6c4f7068f3c205e |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-12T07:24:34Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-1c1d52dc6fbc4968a6c4f7068f3c205e2022-12-22T03:42:13ZengBMCWorld Journal of Surgical Oncology1477-78192017-11-011511810.1186/s12957-017-1273-6Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysisXuan Li0Danian Dai1Bo Chen2Hailin Tang3Weidong Wei4Present Address: Department of Breast Oncology, Sun Yat-Sen University Cancer CenterPresent Address: Department of Breast Oncology, Sun Yat-Sen University Cancer CenterPresent Address: Department of Breast Oncology, Sun Yat-Sen University Cancer CenterPresent Address: Department of Breast Oncology, Sun Yat-Sen University Cancer CenterPresent Address: Department of Breast Oncology, Sun Yat-Sen University Cancer CenterAbstract Background With limited sample sizes and single-institution designs, how complete response (CR) after neoadjuvant chemotherapy (NAC) influences breast conserving surgery (BCS) and its value in prognosis are not clear. Methods A systematic research review was conducted using electronic database. The rate of clinical complete response (cCR) in BCS after NAC and these pathological CR (PCR) and non-pCR BCS patients’ local recurrence-free survival (LRFS), distance recurrence-free survival (DRFS), overall survival (OS), and disease-free survival (DFS) rates were collected. A pooled analysis was performed using a fixed or random effects model and a Q test to determine heterogeneity. Results Sixteen studies with a total of 4639 patients were included. The pooled data revealed that cCR patients compared with non-cCR patients had significantly higher rates of BCS, with a summary estimate odds ratios (OR) of 4.54 (95% CI 2.03–10.17). The pooled data revealed that BCS patients who achieved pCR after NAC had significantly lower rates of LRFS (RR = 0.59, 95% CI 0.38–0.92) and DRFS (RR = 0.27, 95% CI 0.13–0.55). Better DFS (RR = 0.09, 95% CI 0.04–0.25) and OS (RR = 0.36, 95% CI 0.03–3.90) were also seen, but OS was not significantly different. Conclusions The rate of successful BCS is higher in the cCR group than in the non-cCR group, means cCR after NAC can encourage patients to receive BCS. The achievement of pCR after NAC in BCS patients was associated with a good prognosis in terms of LRFS and DRFS, but its value in DFS and OS requires further investigation.http://link.springer.com/article/10.1186/s12957-017-1273-6NeoadjuvantChemotherapyBreast cancerChemotherapy responsePredictive value |
| spellingShingle | Xuan Li Danian Dai Bo Chen Hailin Tang Weidong Wei Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis World Journal of Surgical Oncology Neoadjuvant Chemotherapy Breast cancer Chemotherapy response Predictive value |
| title | Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis |
| title_full | Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis |
| title_fullStr | Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis |
| title_full_unstemmed | Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis |
| title_short | Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis |
| title_sort | oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery a systematic review and meta analysis |
| topic | Neoadjuvant Chemotherapy Breast cancer Chemotherapy response Predictive value |
| url | http://link.springer.com/article/10.1186/s12957-017-1273-6 |
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