Plastic and reconstructive surgery · 2025
Hospital Setting Impact on Breast Cancer-Related Lymphedema and Quality of Life after Immediate Lymphatic Reconstruction.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Hassan Abbas M, Hajj John P, Lewis John P, Ahmed Shahnur, Fisher Carla S, Danforth Rachel M, VonDerHaar R Jason, Bamba Ravinder, Lester Mary E, Hassanein Aladdin H
Аннотация
BACKGROUND: Hospital setting may influence surgical outcomes, but its impact on immediate lymphatic reconstruction (ILR) for preventing breast cancer-related lymphedema (BCRL) after axillary lymph node dissection is unknown. This study assesses BCRL incidence and related outcomes after ILR comparing academic and community hospitals within a multihospital network.
METHODS: The authors retrospectively studied consecutive patients who underwent ILR after axillary lymph node dissection between 2017 and 2024 across 6 hospitals. Hospitals were categorized as academic or community-based. The primary outcome (BCRL incidence) and secondary outcomes (complications and patient-reported outcomes [LYMPH-Q]) were compared using multivariable regression models adjusting for patient and treatment factors.
RESULTS: The authors identified 172 patients with a mean age 50.9 ± 11.6 years, body mass index of 29.5 ± 6.9 kg/m 2 , and follow-up time of 23.1 ± 15.2 months. ILR occurred at academic hospitals in 88 patients (51.2%) and at community hospitals in 84 patients (48.8%). BCRL incidence was comparable between academic (6.8%) and community (7.1%) settings ( P = 0.933). In multivariable regression, hospital setting was not significantly associated with the odds of developing BCRL (odds ratio [OR], 0.80; P = 0.730), surgical complications (OR, 1.21; P = 0.642), unplanned reoperation (OR, 1.43; P = 0.418), or LYMPH-Q Symptoms (β, -11.20; P = 0.063), Function (β, -4.9; P = 0.834), Appearance (β, -7.16; P = 0.413), or Psychological Well-Being (β, -5.25; P = 0.504) scales.
CONCLUSIONS: ILR demonstrated comparable outcomes for BCRL incidence, complications, and patient-reported quality of life between academic and community settings. These findings suggest that ILR can be successfully implemented beyond traditional academic centers with appropriate surgeon expertise and institutional support, potentially improving access to preventative lymphedema surgery.
METHODS: The authors retrospectively studied consecutive patients who underwent ILR after axillary lymph node dissection between 2017 and 2024 across 6 hospitals. Hospitals were categorized as academic or community-based. The primary outcome (BCRL incidence) and secondary outcomes (complications and patient-reported outcomes [LYMPH-Q]) were compared using multivariable regression models adjusting for patient and treatment factors.
RESULTS: The authors identified 172 patients with a mean age 50.9 ± 11.6 years, body mass index of 29.5 ± 6.9 kg/m 2 , and follow-up time of 23.1 ± 15.2 months. ILR occurred at academic hospitals in 88 patients (51.2%) and at community hospitals in 84 patients (48.8%). BCRL incidence was comparable between academic (6.8%) and community (7.1%) settings ( P = 0.933). In multivariable regression, hospital setting was not significantly associated with the odds of developing BCRL (odds ratio [OR], 0.80; P = 0.730), surgical complications (OR, 1.21; P = 0.642), unplanned reoperation (OR, 1.43; P = 0.418), or LYMPH-Q Symptoms (β, -11.20; P = 0.063), Function (β, -4.9; P = 0.834), Appearance (β, -7.16; P = 0.413), or Psychological Well-Being (β, -5.25; P = 0.504) scales.
CONCLUSIONS: ILR demonstrated comparable outcomes for BCRL incidence, complications, and patient-reported quality of life between academic and community settings. These findings suggest that ILR can be successfully implemented beyond traditional academic centers with appropriate surgeon expertise and institutional support, potentially improving access to preventative lymphedema surgery.