Does oncoplastic surgery increase immediate (30-day) postoperative complications? An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database
Purpose Although there has been a significant increase in the use of oncoplastic surgery (OPS), data on the postoperative safety of this approach are limited compared to traditional lumpectomy. This study aimed to compare the immediate (30-day) postoperative complications associated with OPS and tra...
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| Veröffentlicht in: | Breast cancer research and treatment 2020-07, Vol.182 (2), p.429-438 |
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| creator | Angarita, Fernando A. Acuna, Sergio A. Cordeiro, Erin McCready, David R. Cil, Tulin D. |
| description | Purpose
Although there has been a significant increase in the use of oncoplastic surgery (OPS), data on the postoperative safety of this approach are limited compared to traditional lumpectomy. This study aimed to compare the immediate (30-day) postoperative complications associated with OPS and traditional lumpectomy.
Methods
An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was performed on women with breast cancer who underwent OPS or traditional lumpectomy. Logistic regression was used to explore the effect of type of surgery on the outcome of interest.
Results
A total of 109,487 women were analyzed of whom 8.3% underwent OPS. OPS had a longer median operative time than traditional lumpectomy. The unadjusted immediate (30-day) overall complication rate was significantly higher with OPS than traditional lumpectomy (3.8% versus 2.6%,
p
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| doi_str_mv | 10.1007/s10549-020-05665-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2406577855</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2406577855</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-eb607daf823b37e007c863da1129c67e403557393f78a9fff1a9df260eb2e9143</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS0EosPAC7BAlthMFwE7Tux4hUbD30hVaTWwjhznZnDlxMF2KuVt-ixd8Fx4ZgpILFhZvv7Oudf3IPSSkjeUEPE2UFIWMiM5yUjJeZlVj9CCloJlIqfiMVoQykXGK8LP0LMQbgghUhD5FJ2xvCgkEXKBfr53ELAbtButCtFoHCa_Bz9jM2gPKgA2fQ-tURHwipGsVfP5_d3oQnQjeBXNLdzfadeP1uh0c0N4h9cDVoOyczDJusPxO-B1Dz4BA944a2EPh_ru0CkJ8OVRqOyxkiiLrydlTZzxth-9u4UehoivvNt71ePVerPDl7vr7dU5blVUTRryOXrSKRvgxcO5RN8-fvi6-ZxdfPm03awvMs1EGTNoOBGt6qqcNUxAWqKuOGsVpbnUXEBBWJn2J1knKiW7rqNKtl3OCTQ5SFqwJVqdfNNYPyYIse5N0GCtGsBNoc4LwkshqrJM6Ot_0Bs3-fTLA0VZRYsqNVqi_ERp70Lw0NWjN73yc01JfUi5PqVcp5TrY8p1lUSvHqynJmXzR_I71gSwExDS05Di_Nv7P7a_ANPrto0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2413814839</pqid></control><display><type>article</type><title>Does oncoplastic surgery increase immediate (30-day) postoperative complications? An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Angarita, Fernando A. ; Acuna, Sergio A. ; Cordeiro, Erin ; McCready, David R. ; Cil, Tulin D.</creator><creatorcontrib>Angarita, Fernando A. ; Acuna, Sergio A. ; Cordeiro, Erin ; McCready, David R. ; Cil, Tulin D.</creatorcontrib><description>Purpose
Although there has been a significant increase in the use of oncoplastic surgery (OPS), data on the postoperative safety of this approach are limited compared to traditional lumpectomy. This study aimed to compare the immediate (30-day) postoperative complications associated with OPS and traditional lumpectomy.
Methods
An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was performed on women with breast cancer who underwent OPS or traditional lumpectomy. Logistic regression was used to explore the effect of type of surgery on the outcome of interest.
Results
A total of 109,487 women were analyzed of whom 8.3% underwent OPS. OPS had a longer median operative time than traditional lumpectomy. The unadjusted immediate (30-day) overall complication rate was significantly higher with OPS than traditional lumpectomy (3.8% versus 2.6%,
p
< 0.001). After adjusting for baseline differences, overall 30-day postoperative complications were significantly higher amongst women undergoing OPS compared with traditional lumpectomy (OR 1.41, 95%CI 1.24–1.59). Factors that were independent predictors of overall 30-day complications included higher age, higher BMI, race, smoking status, lymph node surgery, neoadjuvant chemotherapy, ASA class ≥ 3, in situ disease, and year of operation. The interaction term between type of surgery and operative time was not statistically significant, indicating that operative time did not modify the effect of type of surgery on immediate postoperative complications.
Conclusions
Although there were slightly higher overall complication rates with OPS, the absolute rates remained quite low for both groups. Therefore, OPS may be performed in women with breast cancer who are suitable candidates.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-020-05665-8</identifier><identifier>PMID: 32449079</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Aged ; Breast - pathology ; Breast - surgery ; Breast cancer ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Cancer research ; Chemotherapy ; Databases, Factual - statistics & numerical data ; Epidemiology ; Feasibility Studies ; Female ; Global Burden of Disease - statistics & numerical data ; Hospital Mortality ; Humans ; Lumpectomy ; Lymph nodes ; Mammaplasty - adverse effects ; Mammaplasty - methods ; Mastectomy, Segmental - adverse effects ; Mastectomy, Segmental - methods ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Complications - prevention & control ; Quality control ; Quality improvement ; Quality Improvement - statistics & numerical data ; Retrospective Studies ; Statistical analysis ; Surgery ; Treatment Outcome</subject><ispartof>Breast cancer research and treatment, 2020-07, Vol.182 (2), p.429-438</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-eb607daf823b37e007c863da1129c67e403557393f78a9fff1a9df260eb2e9143</citedby><cites>FETCH-LOGICAL-c375t-eb607daf823b37e007c863da1129c67e403557393f78a9fff1a9df260eb2e9143</cites><orcidid>0000-0002-8546-7309</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-020-05665-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-020-05665-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32449079$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Angarita, Fernando A.</creatorcontrib><creatorcontrib>Acuna, Sergio A.</creatorcontrib><creatorcontrib>Cordeiro, Erin</creatorcontrib><creatorcontrib>McCready, David R.</creatorcontrib><creatorcontrib>Cil, Tulin D.</creatorcontrib><title>Does oncoplastic surgery increase immediate (30-day) postoperative complications? An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Purpose
Although there has been a significant increase in the use of oncoplastic surgery (OPS), data on the postoperative safety of this approach are limited compared to traditional lumpectomy. This study aimed to compare the immediate (30-day) postoperative complications associated with OPS and traditional lumpectomy.
Methods
An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was performed on women with breast cancer who underwent OPS or traditional lumpectomy. Logistic regression was used to explore the effect of type of surgery on the outcome of interest.
Results
A total of 109,487 women were analyzed of whom 8.3% underwent OPS. OPS had a longer median operative time than traditional lumpectomy. The unadjusted immediate (30-day) overall complication rate was significantly higher with OPS than traditional lumpectomy (3.8% versus 2.6%,
p
< 0.001). After adjusting for baseline differences, overall 30-day postoperative complications were significantly higher amongst women undergoing OPS compared with traditional lumpectomy (OR 1.41, 95%CI 1.24–1.59). Factors that were independent predictors of overall 30-day complications included higher age, higher BMI, race, smoking status, lymph node surgery, neoadjuvant chemotherapy, ASA class ≥ 3, in situ disease, and year of operation. The interaction term between type of surgery and operative time was not statistically significant, indicating that operative time did not modify the effect of type of surgery on immediate postoperative complications.
Conclusions
Although there were slightly higher overall complication rates with OPS, the absolute rates remained quite low for both groups. Therefore, OPS may be performed in women with breast cancer who are suitable candidates.</description><subject>Aged</subject><subject>Breast - pathology</subject><subject>Breast - surgery</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer research</subject><subject>Chemotherapy</subject><subject>Databases, Factual - statistics & numerical data</subject><subject>Epidemiology</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Global Burden of Disease - statistics & numerical data</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Lumpectomy</subject><subject>Lymph nodes</subject><subject>Mammaplasty - adverse effects</subject><subject>Mammaplasty - methods</subject><subject>Mastectomy, Segmental - adverse effects</subject><subject>Mastectomy, Segmental - methods</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Quality control</subject><subject>Quality improvement</subject><subject>Quality Improvement - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kc1u1DAUhS0EosPAC7BAlthMFwE7Tux4hUbD30hVaTWwjhznZnDlxMF2KuVt-ixd8Fx4ZgpILFhZvv7Oudf3IPSSkjeUEPE2UFIWMiM5yUjJeZlVj9CCloJlIqfiMVoQykXGK8LP0LMQbgghUhD5FJ2xvCgkEXKBfr53ELAbtButCtFoHCa_Bz9jM2gPKgA2fQ-tURHwipGsVfP5_d3oQnQjeBXNLdzfadeP1uh0c0N4h9cDVoOyczDJusPxO-B1Dz4BA944a2EPh_ru0CkJ8OVRqOyxkiiLrydlTZzxth-9u4UehoivvNt71ePVerPDl7vr7dU5blVUTRryOXrSKRvgxcO5RN8-fvi6-ZxdfPm03awvMs1EGTNoOBGt6qqcNUxAWqKuOGsVpbnUXEBBWJn2J1knKiW7rqNKtl3OCTQ5SFqwJVqdfNNYPyYIse5N0GCtGsBNoc4LwkshqrJM6Ot_0Bs3-fTLA0VZRYsqNVqi_ERp70Lw0NWjN73yc01JfUi5PqVcp5TrY8p1lUSvHqynJmXzR_I71gSwExDS05Di_Nv7P7a_ANPrto0</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Angarita, Fernando A.</creator><creator>Acuna, Sergio A.</creator><creator>Cordeiro, Erin</creator><creator>McCready, David R.</creator><creator>Cil, Tulin D.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8546-7309</orcidid></search><sort><creationdate>20200701</creationdate><title>Does oncoplastic surgery increase immediate (30-day) postoperative complications? An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database</title><author>Angarita, Fernando A. ; Acuna, Sergio A. ; Cordeiro, Erin ; McCready, David R. ; Cil, Tulin D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-eb607daf823b37e007c863da1129c67e403557393f78a9fff1a9df260eb2e9143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Breast - pathology</topic><topic>Breast - surgery</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Cancer research</topic><topic>Chemotherapy</topic><topic>Databases, Factual - statistics & numerical data</topic><topic>Epidemiology</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Global Burden of Disease - statistics & numerical data</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Lumpectomy</topic><topic>Lymph nodes</topic><topic>Mammaplasty - adverse effects</topic><topic>Mammaplasty - methods</topic><topic>Mastectomy, Segmental - adverse effects</topic><topic>Mastectomy, Segmental - methods</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Quality control</topic><topic>Quality improvement</topic><topic>Quality Improvement - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Angarita, Fernando A.</creatorcontrib><creatorcontrib>Acuna, Sergio A.</creatorcontrib><creatorcontrib>Cordeiro, Erin</creatorcontrib><creatorcontrib>McCready, David R.</creatorcontrib><creatorcontrib>Cil, Tulin D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Angarita, Fernando A.</au><au>Acuna, Sergio A.</au><au>Cordeiro, Erin</au><au>McCready, David R.</au><au>Cil, Tulin D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does oncoplastic surgery increase immediate (30-day) postoperative complications? An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2020-07-01</date><risdate>2020</risdate><volume>182</volume><issue>2</issue><spage>429</spage><epage>438</epage><pages>429-438</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><abstract>Purpose
Although there has been a significant increase in the use of oncoplastic surgery (OPS), data on the postoperative safety of this approach are limited compared to traditional lumpectomy. This study aimed to compare the immediate (30-day) postoperative complications associated with OPS and traditional lumpectomy.
Methods
An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was performed on women with breast cancer who underwent OPS or traditional lumpectomy. Logistic regression was used to explore the effect of type of surgery on the outcome of interest.
Results
A total of 109,487 women were analyzed of whom 8.3% underwent OPS. OPS had a longer median operative time than traditional lumpectomy. The unadjusted immediate (30-day) overall complication rate was significantly higher with OPS than traditional lumpectomy (3.8% versus 2.6%,
p
< 0.001). After adjusting for baseline differences, overall 30-day postoperative complications were significantly higher amongst women undergoing OPS compared with traditional lumpectomy (OR 1.41, 95%CI 1.24–1.59). Factors that were independent predictors of overall 30-day complications included higher age, higher BMI, race, smoking status, lymph node surgery, neoadjuvant chemotherapy, ASA class ≥ 3, in situ disease, and year of operation. The interaction term between type of surgery and operative time was not statistically significant, indicating that operative time did not modify the effect of type of surgery on immediate postoperative complications.
Conclusions
Although there were slightly higher overall complication rates with OPS, the absolute rates remained quite low for both groups. Therefore, OPS may be performed in women with breast cancer who are suitable candidates.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32449079</pmid><doi>10.1007/s10549-020-05665-8</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-8546-7309</orcidid></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Aged Breast - pathology Breast - surgery Breast cancer Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - surgery Cancer research Chemotherapy Databases, Factual - statistics & numerical data Epidemiology Feasibility Studies Female Global Burden of Disease - statistics & numerical data Hospital Mortality Humans Lumpectomy Lymph nodes Mammaplasty - adverse effects Mammaplasty - methods Mastectomy, Segmental - adverse effects Mastectomy, Segmental - methods Medicine Medicine & Public Health Middle Aged Oncology Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - prevention & control Quality control Quality improvement Quality Improvement - statistics & numerical data Retrospective Studies Statistical analysis Surgery Treatment Outcome |
| title | Does oncoplastic surgery increase immediate (30-day) postoperative complications? An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database |
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