Objective:The number of immediate breast reconstruction(IBR)procedures has been increasing in China.This study aimed to investigate the oncological safety of IBR,and to compare the survival and surgical outcomes betwe...Objective:The number of immediate breast reconstruction(IBR)procedures has been increasing in China.This study aimed to investigate the oncological safety of IBR,and to compare the survival and surgical outcomes between implant-based and autologous reconstruction.Methods:Data from patients diagnosed with invasive breast cancer who underwent immediate total breast reconstruction between 2001 and 2016 were retrospectively reviewed.Long-term breast cancer-specific survival(BCSS),disease-free survival(DFS),and locoregional recurrence-free survival(LRFS)were evaluated.Patient satisfaction with the breast was compared between the implantbased and autologous groups.BCSS,DFS,and LRFS were compared between groups after propensity score matching(PSM).Results:A total of 784 IBR procedures were identified,of which 584 were performed on patients with invasive breast cancer(implantbased,n=288;autologous,n=296).With a median follow-up of 71.3 months,the 10-year estimates of BCSS,DFS,and LRFS were 88.9%[95%confidence interval(CI)(85.1%–93.0%)],79.6%[95%CI(74.7%–84.8%)],and 94.0%[95%CI(90.3%–97.8%)],respectively.A total of 124 patients completed the Breast-Q questionnaire,and no statistically significant differences were noted between groups(P=0.823).After PSM with 27 variables,no statistically significant differences in BCSS,DFS,and LRFS were found between the implant-based(n=177)and autologous(n=177)groups.Further stratification according to staging,histological grade,lymph node status,and lymph-venous invasion status revealed no significant survival differences between groups.Conclusions:Both immediate implant-based and autologous reconstruction were reasonable choices with similar long-term oncological outcomes and patient-reported satisfaction among patients with invasive breast cancer in China.展开更多
Carbon fiber reinforced polyetheretherketone(CFRPEEK)possesses a similar elastic modulus to that of human cortical bone and is considered as a promising candidate to replace metallic implants.However,the bioinertness ...Carbon fiber reinforced polyetheretherketone(CFRPEEK)possesses a similar elastic modulus to that of human cortical bone and is considered as a promising candidate to replace metallic implants.However,the bioinertness and deficiency of antibacterial activities impede its application in orthopedic and dentistry.In this work,titanium plasma immersion ion implantation(Ti-PⅢ)is applied to modify CFRPEEK,achieving unique multi-hierarchical nanostructures and active sites on the surface.Then,hybrid polydopamine(PDA)@ZnO-EDN1 nanoparticles(NPs)are introduced to construct versatile surfaces with improved osteogenic and angiogenic properties and excellent antibacterial properties.Our study established that the modified CFRPEEK presented favorable stability and cytocompatibility.Compared with bare CFRPEEK,improved osteogenic differentiation of rat mesenchymal stem cells(BMSCs)and vascularization of human umbilical vein endothelial cells(HUVECs)are found on the functionalized surface due to the zinc ions and EDN1 releasing.In vitro bacteriostasis assay confirms that hybrid PDA@ZnO NPs on the functionalized surface provided an effective antibacterial effect.Moreover,the rat infected model corroborates the enhanced antibiosis and osteointegration of the functionalized CFRPEEK.Our findings indicate that the multilevel nanostructured PDA@ZnO-EDN1 coated CFRPEEK with enhanced antibacterial,angiogenic,and osteogenic capacity has great potential as an orthopedic/dental implant material for clinical application.展开更多
基金supported by the Tianjin“Belt and Road”Technological Innovation and Cooperation Grant(Grant No.18PTZWHZ00050)the Special Foundation for Project and Team Development Grant(Grant No.XB202008).
文摘Objective:The number of immediate breast reconstruction(IBR)procedures has been increasing in China.This study aimed to investigate the oncological safety of IBR,and to compare the survival and surgical outcomes between implant-based and autologous reconstruction.Methods:Data from patients diagnosed with invasive breast cancer who underwent immediate total breast reconstruction between 2001 and 2016 were retrospectively reviewed.Long-term breast cancer-specific survival(BCSS),disease-free survival(DFS),and locoregional recurrence-free survival(LRFS)were evaluated.Patient satisfaction with the breast was compared between the implantbased and autologous groups.BCSS,DFS,and LRFS were compared between groups after propensity score matching(PSM).Results:A total of 784 IBR procedures were identified,of which 584 were performed on patients with invasive breast cancer(implantbased,n=288;autologous,n=296).With a median follow-up of 71.3 months,the 10-year estimates of BCSS,DFS,and LRFS were 88.9%[95%confidence interval(CI)(85.1%–93.0%)],79.6%[95%CI(74.7%–84.8%)],and 94.0%[95%CI(90.3%–97.8%)],respectively.A total of 124 patients completed the Breast-Q questionnaire,and no statistically significant differences were noted between groups(P=0.823).After PSM with 27 variables,no statistically significant differences in BCSS,DFS,and LRFS were found between the implant-based(n=177)and autologous(n=177)groups.Further stratification according to staging,histological grade,lymph node status,and lymph-venous invasion status revealed no significant survival differences between groups.Conclusions:Both immediate implant-based and autologous reconstruction were reasonable choices with similar long-term oncological outcomes and patient-reported satisfaction among patients with invasive breast cancer in China.
基金funded by the National Natural Science Foundation of China(No.81921002,No.82100963,No.81873709)the Natural Science Foundation of Shanghai Science and Technology Commission(21ZR1437100)Shanghai Rising-Star Program(21QA1405400).
文摘Carbon fiber reinforced polyetheretherketone(CFRPEEK)possesses a similar elastic modulus to that of human cortical bone and is considered as a promising candidate to replace metallic implants.However,the bioinertness and deficiency of antibacterial activities impede its application in orthopedic and dentistry.In this work,titanium plasma immersion ion implantation(Ti-PⅢ)is applied to modify CFRPEEK,achieving unique multi-hierarchical nanostructures and active sites on the surface.Then,hybrid polydopamine(PDA)@ZnO-EDN1 nanoparticles(NPs)are introduced to construct versatile surfaces with improved osteogenic and angiogenic properties and excellent antibacterial properties.Our study established that the modified CFRPEEK presented favorable stability and cytocompatibility.Compared with bare CFRPEEK,improved osteogenic differentiation of rat mesenchymal stem cells(BMSCs)and vascularization of human umbilical vein endothelial cells(HUVECs)are found on the functionalized surface due to the zinc ions and EDN1 releasing.In vitro bacteriostasis assay confirms that hybrid PDA@ZnO NPs on the functionalized surface provided an effective antibacterial effect.Moreover,the rat infected model corroborates the enhanced antibiosis and osteointegration of the functionalized CFRPEEK.Our findings indicate that the multilevel nanostructured PDA@ZnO-EDN1 coated CFRPEEK with enhanced antibacterial,angiogenic,and osteogenic capacity has great potential as an orthopedic/dental implant material for clinical application.
