Title |
Oncological outcome of complete response after neoadjuvant chemotherapy for breast conserving surgery: a systematic review and meta-analysis
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Published in |
World Journal of Surgical Oncology, November 2017
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DOI | 10.1186/s12957-017-1273-6 |
Pubmed ID | |
Authors |
Xuan Li, Danian Dai, Bo Chen, Hailin Tang, Weidong Wei |
Abstract |
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. 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. 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. 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. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 38 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 7 | 18% |
Researcher | 4 | 11% |
Student > Postgraduate | 3 | 8% |
Student > Bachelor | 3 | 8% |
Lecturer | 2 | 5% |
Other | 9 | 24% |
Unknown | 10 | 26% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 16 | 42% |
Nursing and Health Professions | 4 | 11% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 5% |
Unspecified | 1 | 3% |
Sports and Recreations | 1 | 3% |
Other | 3 | 8% |
Unknown | 11 | 29% |