医学
脂肪坏死
坏死
外科
化疗
乳腺癌
逻辑回归
乳房再造术
单变量分析
相对风险
内科学
置信区间
癌症
多元分析
作者
Lin Li,Ying Chen,Jiaying Chen,Jiajian Chen,Benlong Yang,Junjie Li,Xiaoyan Huang,Zhenzhou Shen,Zhimin Shao,Peirong Yu,Jiong Wu
标识
DOI:10.1016/j.bjps.2014.01.008
摘要
Background Fat necrosis is one of the most common complications following free flap breast reconstruction. Although a minor complication, fat necrosis can compromise esthetic results and confuse with cancer recurrence. Perfusion-related factors and post-operative radiotherapy are the known risks. However, the influence of adjuvant chemotherapy on fat necrosis prevalence remains unknown. Methods Our initial experience of 88 consecutive breast reconstructions with free abdominal flaps was reviewed. The prevalence of fat necrosis was recorded and the risk factors were analyzed using univariate and multivariate logistic regression models. Results The overall prevalence of fat necrosis was 36.4% in this series. In a multivariate logistic regression model, adjuvant chemotherapy significantly increased the risk of fat necrosis. The relative risk was 4.762 (95% confidence interval (CI), 1.767–12.831; p = 0.002). There was no evidence of a specific chemotherapeutic agent causing fat necrosis. The first cycle of adjuvant chemotherapy was frequently delivered earlier in patients with fat necrosis than those without fat necrosis, although this tendency was not statistically significant. Conclusions Our initial experience with free flap breast reconstruction seems to suggest that chemotherapy may increase the risk of fat necrosis following immediate breast reconstruction. Patients should be fully informed, and the initiation of post-operative chemotherapy may be adjusted accordingly.
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