Efficacy of Immediate Lymphatic Reconstruction in Prevention of Breast Cancer-Related Lymphedema: A Systematic Review and Meta-Analysis

Resumo original em inglês

O que aconteceu

Immediate lymphatic reconstruction (ILR) is a technique in which lymphatics are visualized and lymphovenous bypass is done at the time of axillary lymph node dissection (ALND) to prevent breast cancer-related lymphedema (BCRL). This meta-analysis estimates the benefit of ILR in preventing lymphedema by incorporating double- and single-arm studies and stratifying by length of follow-up time.

Three databases were queried for studies with primary data on ILR. Both double- and single-armed studies were included, and papers with small sample sizes, overlapping samples, and unreported data were excluded. Treatment effects were calculated with risk ratios and converted to a logarithmic scale. A meta-analysis was performed using the inverse variance method and a random-effects model, with further analysis done by study design and length of follow-up time.

O que encontraram

A total of 17 studies were included (9 double-arm and 8 single-arm; n = 2607). The pooled treatment effect of ILR, expressed as log risk ratio (95% CI), was -0.89 (-1.18, -0.60; p < 0.0001). This corresponds to a relative risk of 0.41 (0.31, 0.55) and a number needed to treat of 9. Double- and single-arm studies showed no significant differences in effect sizes. Studies with < 1-year follow-up demonstrated a larger effect size than those with longer follow-up, and the benefits of ILR were no longer significant past 3 years.

Por que isso importa

Patients receiving ILR were significantly less likely to develop BCRL than those receiving ALND alone. Further work is needed to examine whether benefits can truly be sustained long-term.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.