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Your search keyword '"O'Connell, Rachel L."' showing total 12 results
Start Over Author "O'Connell, Rachel L." Publisher lippincott williams & wilkins
12 results on '"O'Connell, Rachel L."'

2. Symptom Burden and Quality of Life With Chemotherapy for Recurrent Ovarian Cancer: The Gynecologic Cancer InterGroup-Symptom Benefit Study.

Author

Lee, Yeh Chen, King, Madeleine T., O'Connell, Rachel L., Lanceley, Anne, Joly, Florence, Hilpert, Felix, Davis, Alison, Roncolato, Felicia T., Okamoto, Aikou, Bryce, Jane, Donnellan, Paul, Oza, Amit M., Avall-Lundqvist, Elisabeth, Berek, Jonathan S., Ledermann, Jonathan A., Berton, Dominique, Sehouli, Jalid, Feeney, Amanda, Kaminsky, Marie-Christine, and Diamante, Katrina

Published
2022
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12. Comparison of Immediate versus Delayed DIEP Flap Reconstruction in Women Who Require Postmastectomy Radiotherapy.

Author

O'Connell RL, Di Micco R, Khabra K, Kirby AM, Harris PA, James SE, Power K, Ramsey KWD, and Rusby JE

Subjects
Adult, Aged, Breast Neoplasms surgery, Epigastric Arteries surgery, Esthetics, Female, Humans, Middle Aged, Patient Reported Outcome Measures, Radiotherapy, Adjuvant, Retrospective Studies, Time Factors, Breast Neoplasms radiotherapy, Mammaplasty methods, Mastectomy, Patient Satisfaction statistics & numerical data, Perforator Flap
Abstract

Background: The authors investigated aesthetic outcome and patient satisfaction in women who have undergone deep inferior epigastric artery perforator (DIEP) flap reconstruction in the setting of postmastectomy radiotherapy. Patients who underwent DIEP flap reconstruction without postmastectomy radiotherapy were the control group., Methods: Participants who had undergone DIEP flap reconstruction between September 1, 2009, and September 1, 2014, were recruited, answered the BREAST-Q, and underwent three-dimensional surface-imaging. A panel assessed the aesthetic outcome by reviewing these images., Results: One hundred sixty-seven women participated. Eighty women (48 percent) underwent immediate DIEP flap reconstruction and no postmastectomy radiotherapy; 28 (17 percent) underwent immediate DIEP flap reconstruction with postmastectomy radiotherapy; 38 (23 percent) underwent simple mastectomy, postmastectomy radiotherapy, and DIEP flap reconstruction; and 21 (13 percent) underwent mastectomy with temporizing implant, postmastectomy radiotherapy, and DIEP flap reconstruction. Median satisfaction scores were significantly different among the groups (p < 0.05). Post hoc comparison demonstrated that women who had an immediate DIEP flap reconstruction were significantly less satisfied if they had postmastectomy radiotherapy. In women requiring radiotherapy, those undergoing delayed reconstruction after a simple mastectomy were most satisfied, but there was no significant difference between the immediate DIEP flap and temporizing implant groups. Median panel scores differed among groups, being significantly higher if the immediate reconstruction was not subjected to radiotherapy. There was no significant difference in panel assessment among the three groups of women who had received radiotherapy., Conclusions: Patients who avoid having their immediate DIEP flap reconstruction irradiated are more satisfied and have better aesthetic outcome than those who undergo postmastectomy radiotherapy. In women requiring radiotherapy and who wish to have an immediate or "delayed-immediate" reconstruction, there were no significant differences in panel or patient satisfaction. Therefore, immediate DIEP flap reconstruction or mastectomy with temporizing implant then DIEP flap surgery are acceptable treatment pathways in the context of post-mastectomy radiotherapy.

Published
2018
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