The relationship between time to surgery after neoadjuvant chemotherapy and survival in breast cancer patients:a meta-analysis

Abstract PURPOSE: This meta-analysis aims to evaluate the impact of delaying surgery in operable breast tumor patients after neoadjuvant chemotherapy (NAC) on survival. METHODS:An electronic literature retrieval was conducted on PubMed/Medline and EMBASE((between January 2000 and June 2020).The primary end point was overall survival(OS),secondary end points included disease-free survival (DFS) or recurence-free survival (RFS).The HR with 95% confidence intervals were calculated using a random-effects or fixed-effects model. RESULTS:The combined HR for OS was 1.51 (95% CI:1.30-1.76; P=0.000) by fixed effects model.No statistically significant heterogeneity was found (P=0.168, I 2 =31.3%).The pooled HR for RFS/DFS was 1.59 (95%CI:1.30-1.95,I 2 = 66.0%) by random-effects model,with significant heterogeneity. CONCLUSION:Our meta-analysis revealed a significant adverse association between longer TTS after NAC and more inferior OS and RFS/DFS in patients with breast cancer.Clinicians and patients should minimize surgical delay after NAC as much as possible.