Takaaki Konishi1,2, Michimasa Fujiogi3,4, Nobuaki Michihata5, Kojiro Morita3,6, Hiroki Matsui3, Kiyohide Fushimi7, Masahiko Tanabe8, Yasuyuki Seto8,9, Hideo Yasunaga3. 1. Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. takaakonishi-ncd@umin.ac.jp. 2. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. takaakonishi-ncd@umin.ac.jp. 3. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. 4. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02114, USA. 5. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. 6. Department of Health Services, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577, Japan. 7. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan. 8. Department of Breast and Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. 9. Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Abstract
PURPOSE: Although long-term survival is similar between men and women, little is known about the short-term outcomes following breast cancer surgery in men. This study was performed to compare postoperative outcomes adjusted for background factors between men and women with breast cancer using a Japanese nationwide inpatient database. METHODS: This study included 2126 men and 363,468 women who underwent surgery for stage 0-III breast cancer from July 2010 to March 2017. We generated a 1:4 matched-pair cohort matched for age, institution, and fiscal year at admission. We then conducted multivariable regression analyses to compare postoperative complications, 30-day readmission, duration of anesthesia, length of hospitalization, and total hospitalization costs between the sexes. RESULTS: Men were older, more likely to have comorbidities and advanced cancer, and more likely to undergo total mastectomy and axillary dissection than women. There were no significant differences in postoperative complications between the sexes, but men showed a lower risk of 30-day readmission (odds ratio 0.74; 95% confidence interval [CI] 0.57-0.95), shorter duration of anesthesia (difference - 22.0 min; 95% CI - 2.1 to - 0.5), shorter length of hospitalization (difference - 1.3 days; 95% CI - 2.1 to - 0.5), and lower total hospitalization costs (difference - 506 US dollars; 95% CI - 668 to - 334) than women. CONCLUSIONS: The matched-pair cohort analyses revealed no significant differences in postoperative complications between men and women with breast cancer. However, men showed better outcomes than women in terms of 30-day readmission, duration of anesthesia, length of hospitalization, and total hospitalization costs.
PURPOSE: Although long-term survival is similar between men and women, little is known about the short-term outcomes following breast cancer surgery in men. This study was performed to compare postoperative outcomes adjusted for background factors between men and women with breast cancer using a Japanese nationwide inpatient database. METHODS: This study included 2126 men and 363,468 women who underwent surgery for stage 0-III breast cancer from July 2010 to March 2017. We generated a 1:4 matched-pair cohort matched for age, institution, and fiscal year at admission. We then conducted multivariable regression analyses to compare postoperative complications, 30-day readmission, duration of anesthesia, length of hospitalization, and total hospitalization costs between the sexes. RESULTS:Men were older, more likely to have comorbidities and advanced cancer, and more likely to undergo total mastectomy and axillary dissection than women. There were no significant differences in postoperative complications between the sexes, but men showed a lower risk of 30-day readmission (odds ratio 0.74; 95% confidence interval [CI] 0.57-0.95), shorter duration of anesthesia (difference - 22.0 min; 95% CI - 2.1 to - 0.5), shorter length of hospitalization (difference - 1.3 days; 95% CI - 2.1 to - 0.5), and lower total hospitalization costs (difference - 506 US dollars; 95% CI - 668 to - 334) than women. CONCLUSIONS: The matched-pair cohort analyses revealed no significant differences in postoperative complications between men and women with breast cancer. However, men showed better outcomes than women in terms of 30-day readmission, duration of anesthesia, length of hospitalization, and total hospitalization costs.
Entities:
Keywords:
Male breast cancer; Mastectomy; Postoperative outcomes; Sex differences
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