Breast Reconstruction in Older Women: Should Age Be an Exclusion Criterion?

Bowman, Cameron; Lennox, Peter; Clugston, Patricia A.; Courtemanche, Douglas J.

doi:10.1097/01.prs.0000220473.94654.a4

Cited by 63 publications

(49 citation statements)

References 22 publications

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“…In particular, capsular contracture is specific to implant-based reconstruction, whereas abdominal donor-site complications (e.g., hernia, contour abnormalities, trunk function, and anastomotic complications at the recipient site) are specific to abdominal flap reconstruction. Seven studies 9,13,16,17,26,27,30 reported on capsular contracture, although only one specified the use of the Baker system in classifying this complication. 30 Rates of capsular contracture following tissue expander/implant reconstruction ranged from 0.0 to 33.3 percent (Table 3).…”

Section: Method-specific Complicationsmentioning

confidence: 98%

“…Only a single study also evaluated other abdominal flaps (i.e., DIEP and SIEA flap reconstruction). 17 All were cohort trials, mostly conducted in North America (n = 11), 9,13,14,17,18,[24][25][26][27][28][29] with one each from Croatia/Austria, 15 Italy, 30 and the United Kingdom. 16 The mean follow-up period ranged from 6 months 15 to 60.2 months 18 ( Table 2).…”

Section: Description Of the Included Studiesmentioning

confidence: 99%

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Safety of Tissue Expander/Implant versus Autologous Abdominal Tissue Breast Reconstruction in Postmastectomy Breast Cancer Patients

Tsoi

Ziolkowski

Thoma

et al. 2014

Plastic and Reconstructive Surgery

106

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Section: Method-specific Complicationsmentioning

confidence: 98%

Section: Description Of the Included Studiesmentioning

confidence: 99%

Safety of Tissue Expander/Implant versus Autologous Abdominal Tissue Breast Reconstruction in Postmastectomy Breast Cancer Patients

Tsoi

Ziolkowski

Thoma

et al. 2014

Plastic and Reconstructive Surgery

106

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show abstract

“…This influence of physician bias has been demonstrated in breast cancer, prostate cancer and head and neck cancer [10,11,12,13]. It is unclear how physician selection operates to influence actual treatment outcome in head and neck cancer, which prompted us to conduct this retrospective survey.…”

Section: Introductionmentioning

confidence: 99%

Impact of Tumor Board Recommendations on Treatment Outcome for Locally Advanced Head and Neck Cancer

Nguyen¹,

Vos

Lee

et al. 2008

Oncology

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Background/Aims: To identify physician selection factors in the treatment of locally advanced head and neck cancer and how treatment outcome is affected by Tumor Board recommendations. Methods: A retrospective analysis of 213 patients treated for locally advanced head and neck cancer in a single institution was performed. All treatments followed Tumor Board recommendations: 115 patients had chemotherapy and radiation, and 98 patients received postoperative radiation. Patient characteristics, treatment toxicity, locoregional control and survival between these two treat- ment groups were compared. Patient survival was compared with survival data reported in randomized studies of locally advanced head and neck cancer. Results: There were no differences in comorbidity factors, and T or N stages between the two groups. A statistically significant number of patients with oropharyngeal and oral cavity tumors had chemoradiation and postoperative radiation, respectively (p < 0.0001). Grade 3–4 toxicities during treatment were 48 and 87% for the postoperative radiation and chemoradiation groups, respectively (p = 0.0001). There were no differences in survival, locoregional recurrences and distant metastases between the two groups. Patient survival was comparable to survival rates reported by randomized studies of locally advanced head and neck cancer. Conclusion: Disease sites remained the key determining factor for treatment selection. Multidisciplinary approaches provided optimal treatment outcome for locally advanced head and neck cancer, with overall survival in these patients being comparable to that reported in randomized clinical trials.

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“…Die von den Patienten auch in höherem Lebensalter erwarteten Ergebnisse plastisch-rekonstruktiver Eingriffe, wie z. B. die Brustrekonstruktion, kann bei der Gruppe der über 60-Jährigen jedoch eine notwendige sekundäre Korrekturrate von bis zu 20,5% erreichen [9]. Zwar ist hohes Lebensalter über 70 Jahren per se noch nicht mit einer erhöhten eingriffsspezifischen Komplikationsrate wie z.…”

Section: Patientengruppenunclassified

Postoperative Komplikationen in der plastischen Chirurgie

Vogt

2009

Chirurg

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Plastic surgery covers a broad spectrum of diseases and conditions in the areas of reconstructive surgery, hand, burn and aesthetic surgery. Besides acquired defects or malformations an increasing number of patients are being treated for surgical or multimodal complications. In a considerable number of patients plastic and reconstructive surgery remains the only therapeutic alternative after other therapy has failed. Therefore complication management in plastic surgery is of utmost importance for a successful outcome. In addition patient expectations in the results of plastic surgery as a discipline of invention and problem solving are steadily increasing. This challenge is reflected in clinical patient management by intensive research in tissue engineering and regenerative medicine. Patients in plastic surgery are recruited from all age groups of either gender, involving traumatic and oncologic as well as congenital and aesthetic disorders. The demographics of aging, multimorbidity and obesity pose new challenges to plastic surgery. Although age over 70 years is not an independent risk factor per se for complications in plastic surgery, e.g. for complex free flap transfer, medical problems are present at a higher rate, which is to be expected in this age group. Risk factors such as alcoholism and coronary heart diseases seem to be independent predictors of perioperative complications. Therefore older patients can also benefit from plastic surgery and recurrent operations by the corresponding risk and complication management. Complication management necessitates careful patient selection, estimation of operative risks and patient-adapted selection of procedures. In addition to expertise in plastic surgery a thorough knowledge of non-surgical and surgical back-up procedures for technical incidents as well as vascular circulatory and wound healing disorders is required to deal successfully with complications in plastic surgery. This article presents these specific aspects of postoperative complication management in plastic surgery.

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Breast Reconstruction in Older Women: Should Age Be an Exclusion Criterion?

Abstract: The authors believe that all types of reconstruction should be an option for women older than 60 years of age and that age as an isolated factor should not deter physicians from offering these women the option of breast reconstruction.

Cited by 63 publications

References 22 publications

Safety of Tissue Expander/Implant versus Autologous Abdominal Tissue Breast Reconstruction in Postmastectomy Breast Cancer Patients

Safety of Tissue Expander/Implant versus Autologous Abdominal Tissue Breast Reconstruction in Postmastectomy Breast Cancer Patients

Impact of Tumor Board Recommendations on Treatment Outcome for Locally Advanced Head and Neck Cancer

Postoperative Komplikationen in der plastischen Chirurgie

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