The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres

Table 1

Multivariable hierarchical logistic regression analyses investigating the association between postmastectomy radiotherapy and key postsurgical outcomes and complications. Each estimate is adjusted for age, smoking habits, diabetes mellitus, other autoimmune diseases, type of chemotherapy, axillary dissection, and type of surgical procedure performed (autologous reconstruction, direct to implant, or tissue expander/immediate). Estimates in the second column (multivariable model 2) are additionally adjusted for the BMI.

Dependent variable	Radiotherapy
	Multivariable model 1		Multivariable model 2
	aOR (95% CI)	value^†	aOR (95% CI)	value^†
Outcomes
Failure	2.60 (1.38–4.88)	0.003	2.72 (1.39–5.32)	0.004
Change in type of reconstruction	5.66 (1.20–26.6)	0.028	7.99 (1.36–47.0)	0.021
Explant	2.31 (1.40–3.80)	0.001	2.49 (1.49–4.15)	<0.001
Reintervention	1.24 (0.79–1.94)	0.347	1.49 (0.89–2.48)	0.128
Complications (all procedures)
Any complication	2.00 (1.58–2.54)	<0.001	1.73 (1.33–2.24)	<0.001
Severe complication^1	2.80 (2.09–3.74)	<0.001	2.17 (1.58–2.97)	<0.001
Mild complication^2	1.60 (1.18–2.17)	0.003	1.28 (0.91–1.80)	0.162
Hematoma	0.61 (0.33–1.14)	0.120	0.48 (0.23–1.02)	0.056
Seroma	1.82 (1.23–2.70)	0.003	1.49 (0.92–2.41)	0.101
Cutaneous necrosis	0.91 (0.60–1.39)	0.664	0.68 (0.42–1.10)	0.114
Any infection	1.76 (1.09–2.86)	0.022	1.91 (1.06–3.42)	0.030
Late infection	1.18 (0.52–2.64)	0.693	0.82 (0.28–2.38)	0.713
Complications in DTI and TE/I groups
Capsular contraction	3.18 (2.31–4.37)	<0.001	2.24 (1.57–3.20)	<0.001
Implant exposure	2.05 (1.07–3.92)	0.029	1.94 (0.99–3.79)	0.054
Implant rupture	1.31 (0.49–3.54)	0.591	1.85 (0.64–5.36)	0.258

Values are expressed as absolute frequency (percentage) for categorical variables and as median (interquartile range) for continuous variables. Due to the small sample size and number of events in the group undergoing autologous reconstruction, it was not possible to perform the multivariable regressions using as outcomes the following complications occurring exclusively in this group: liponecrosis, volume loss, pain, hernia, flap necrosis, bulging, and microvascular complications. ^†Chi-squared test for categorical variables; Kruskal–Wallis test for continuous variables. ¹Severe complications: late infection, capsular contraction, implant exposure, implant rupture, hernia, flap necrosis, bulging, and microvascular complications requiring surgery. ²Mild complications: hematoma, seroma, cutaneous necrosis, early infection, abdominal or lumbar pain, liponecrosis, and volume loss. Abbreviations: aOR: adjusted odds ratio; BMI: body mass index; DTI: direct to implant; TE/I: tissue expander/immediate.