Систематический обзор и метаанализ результатов органосохраняющих операций после неоадъювантной терапии у больных раком молочной железы

Автор: Босиева Алана Руслановна, Ермощенкова Мария Владимировна, Зикиряходжаев Азизжон Дильшодович, Волченко Надежда Николаевна

Журнал: Сибирский онкологический журнал @siboncoj

Рубрика: Обзоры

Статья в выпуске: 2 т.20, 2021 года.

Бесплатный доступ

Введение. Неоадъювантная лекарственная терапия (НАЛТ) является распространенным вариантом лечения при раке молочной железы. Одним из основных преимуществ метода является уменьшение размеров опухолевого узла и регрессия метастатически измененных лимфатических узлов. Цель исследования - анализ литературных данных по результатам органосохраняющих операций после неоадъювантной лекарственной терапии в сравнении с адъювантной лекарственной терапией, включающий изучение ширины краев резекции и частоту повторных операций и рецидивов, объема удаляемой ткани, эстетических результатов. Материал и методы. Поиск источников был осуществлен в системах PubMed, Medline, Cochrane Library, из которых получено 1219 оригинальных статей, 1057 были исключены вследствие несоответствия заранее установленным критериям, 162 статьи были изучены на наличие критериев включения: состояние краев резекции, частота реопераций, объем удаляемой ткани и косметические результаты. Заданным параметрам полностью соответствовали 22 исследования. Результаты. В исследованиях, включенных в данный обзор, показаны различная частота положительных краев резекции (2-39,8 %), реопераций (0-45,4 %), объем удаляемых тканей (43,2-268 см3) и вес резецируемых тканей молочной железы (26,4-233 г) после НАЛТ. Заключение. Полученные данные указывают на снижение частоты позитивных краев резекций и реопераций после НАЛТ у больных раком молочной железы (частота позитивных краев резекции после НАЛТ - 5-39,8 %, без НАЛТ - 13,1-46 %; частота реопераций после НАЛТ - 0-45,4 % без НАЛТ - 0-76,5 %), уменьшение объема удаляемой ткани молочной железы (при сТ2-3) без негативного влияния на чистоту краев резекции, что позволяет минимизировать объем хирургического вмешательства и улучшить косметические результаты органосохраняющего лечения.

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Рак молочной железы, неоадъювантная лекарственная терапия, органосохраняющие операции, края резекции, ререзекция, объем удаляемых тканей, рецидив, косметические результаты

Короткий адрес: https://sciup.org/140254421

IDR: 140254421   |   DOI: 10.21294/1814-4861-2021-20-2-118-126

Список литературы Систематический обзор и метаанализ результатов органосохраняющих операций после неоадъювантной терапии у больных раком молочной железы

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