SynthesisBJS open2020
Immediate and delayed autologous abdominal microvascular flap breast reconstruction in patients receiving adjuvant, neoadjuvant or no radiotherapy: a meta-analysis of clinical and quality-of-life outcomes.
Synthesis in BJS open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed.
- Premastectomy Radiotherapy and Immediate Breast Reconstruction: A Randomized Clinical Trial.JAMA network open · 2024Trial
- Postmastectomy Radiation Therapy on Flap Outcomes in Breast Reconstruction: A Systematic Review and Meta-analysis.Plastic and reconstructive surgery. Global open · 2026Article
- Article
- Efficacy of Intraoperative Indocyanine Green Fluorescence Imaging in Determining the Cutoff Area in Pedicled Transverse Rectus Abdominis Myocutaneous Flap (ICT Study).Plastic and reconstructive surgery. Global open · 2025Article
- Breast reconstruction and neoadjuvant radiotherapy (BRENAR) - study protocol for a multicenter, prospective, single-arm pilot study.International journal of surgery protocols · 2025Article
- Article
- Trends and issues in clinical research on satisfaction and quality of life after mastectomy and breast reconstruction: a 5-year scoping review.International journal of clinical oncology · 2023Article
- Complications of Immediate versus Delayed DIEP Reconstruction: A Meta-Analysis of Comparative Studies.Cancers · 2022Review
- Complete Implant Wrapping with Porcine-Derived Acellular Dermal Matrix for the Treatment of Capsular Contracture in Breast Reconstruction: A Case-Control Study.Aesthetic plastic surgery · 2022Article
- Autologous vs. implant-based breast reconstruction after skin- and nipple-sparing mastectomy-A deeper insight considering surgical and patient-reported outcomes.Frontiers in surgery · 2022Article
- Breast Reconstruction: Necessity for Further Standardization of the Current Surgical Techniques Attempting to Facilitate Scientific Evaluation and Select Tailored Individualized Procedures Optimizing Patient Satisfaction.Breast care (Basel, Switzerland) · 2021Review
- Evolving Trends in Surgical Management of Breast Cancer: An Analysis of 30 Years of Practice Changing Papers.Frontiers in oncology · 2021Review
- Immediate versus secondary DIEP flap breast reconstruction: a multicenter outcome study.Archives of gynecology and obstetrics · 2020Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundEffects of postmastectomy radiotherapy (PMRT) on autologous breast reconstruction (BRR) are controversial regarding surgical complications, cosmetic appearance and quality of life (QOL). This systematic review evaluated these outcomes after abdominal free flap reconstruction in patients undergoing postoperative adjuvant radiotherapy (PMRT), preoperative radiotherapy (neoadjuvant radiotherapy) and no radiotherapy, aiming to establish evidence-based optimal timings for radiotherapy and BRR to guide contemporary management.
methodsThe study was registered on PROSPERO (CRD42017077945). Embase, MEDLINE, Google Scholar, CENTRAL, Science Citation Index and ClinicalTrials.gov were searched (January 2000 to August 2018). Study quality and risk of bias were assessed using GRADE and Cochrane's ROBINS-I respectively.
resultsSome 12 studies were identified, involving 1756 patients (350 PMRT, 683 no radiotherapy and 723 neoadjuvant radiotherapy), with a mean follow-up of 27·1 (range 12·0-54·0) months for those having PMRT, 16·8 (1·0-50·3) months for neoadjuvant radiotherapy, and 18·3 (1·0-48·7) months for no radiotherapy. Three prospective and nine retrospective cohorts were included. There were no randomized studies. Five comparative radiotherapy studies evaluated PMRT and four assessed neoadjuvant radiotherapy. Studies were of low quality, with moderate to serious risk of bias. Severe complications were similar between the groups: PMRT versus no radiotherapy (92 versus 141 patients respectively; odds ratio (OR) 2·35, 95 per cent c.i. 0·63 to 8·81, P = 0·200); neoadjuvant radiotherapy versus no radiotherapy (180 versus 392 patients; OR 1·24, 0·76 to 2·04, P = 0·390); and combined PMRT plus neoadjuvant radiotherapy versus no radiotherapy (272 versus 453 patients; OR 1·38, 0·83 to 2·32, P = 0·220). QOL and cosmetic studies used inconsistent methodologies.
conclusionEvidence is conflicting and study quality was poor, limiting recommendations for the timing of autologous BRR and radiotherapy. The impact of PMRT and neoadjuvant radiotherapy appeared to be similar.
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