Preoperative metabolic–inflammatory profiles and early postoperative recovery after immediate breast reconstruction in patients with and without neoadjuvant chemotherapy: a retrospective cohort study
- 1Department of Breast Surgery, Shanxi Cancer Hospital; Cancer Hospital of Chinese Academy of Medical Sciences (Shanxi Hospital); Affiliated Cancer Hospital of Shanxi Medical University
- 2Department of Radiation Therapy, Thoracic Radiotherapy Ward III, Shanxi Provincial Cancer Hospital / Shanxi Hospital, Cancer Hospital, Chinese Academy of Medical Sciences / Third People's Hospital Affiliated to Shanxi Medical University
Abstract
Background: Neoadjuvant chemotherapy (NAC) may influence systemic metabolic-inflammatory status before surgery; however, the association between preoperative biomarker profiles and early recovery after immediate breast reconstruction remains incompletely understood.
Methods: In our retrospective study, we included 214 patients who had immediate breast reconstruction; out of them, 102 patients received NAC, and the other 112 patients didn’t. Preoperative measurements of serum albumin, C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) were performed. The main outcome was prolonged hospitalization, defined as a length of stay (LOS) greater than the cohort median of 8 days; postoperative complications were evaluated separately. Factors associated with prolonged hospitalization were analyzed using multiple logistic regression, and the model’s discrimination was assessed using receiver operating characteristic (ROC) analysis.
Results: Overall, 93 patients (43.5%) experienced prolonged hospitalization. Patients who received NAC were hospitalized longer than those who didn’t (8.6 ± 2.9 days vs 7.2 ± 2.4 days; P = 0.001), and NAC patients also had more complications (28.4% vs 17.0%; P = 0.045). In the multivariable analysis, NAC exposure (OR = 1.82, 95% CI: 1.08–3.05; P = 0.024) and a higher NLR (OR = 1.36, 95% CI: 1.12–1.65; P = 0.002) were independently related to longer length of stay, while a greater level of albumin was negatively related to length of stay (OR = 0.94, 95% CI: 0.90–0.98; P = 0.006). The multivariable model had fair discrimination (AUC = 0.742, 95% CI: 0.676–0.808).
Conclusions: Preoperative albumin and NLR levels may help identify patients at greater risk of prolonged hospitalization; further study is needed for multicenter validation.
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BibTeX
@article{wang2026preoperative,
title = {{Preoperative metabolic–inflammatory profiles and early postoperative recovery after immediate breast reconstruction in patients with and without neoadjuvant chemotherapy: a retrospective cohort study}},
author = {Fan Wang and Lan Yang and Wei Bai and Chengyu Zhao and Yongmin Miao and Wenfu Yang and Yang Liu},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1921109},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1921109/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Preoperative metabolic–inflammatory profiles and early postoperative recovery after immediate breast reconstruction in patients with and without neoadjuvant chemotherapy: a retrospective cohort study
AU - Fan Wang
AU - Lan Yang
AU - Wei Bai
AU - Chengyu Zhao
AU - Yongmin Miao
AU - Wenfu Yang
AU - Yang Liu
PY - 2026
DA - 2026/10/26
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1921109
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1921109/full
AB - Background: Neoadjuvant chemotherapy (NAC) may influence systemic metabolic-inflammatory status before surgery; however, the association between preoperative biomarker profiles and early recovery after immediate breast reconstruction remains incompletely understood. Methods: In our retrospective study, we included 214 patients who had immediate breast reconstruction; out of them, 102 patients received NAC, and the other 112 patients didn’t. Preoperative measurements of serum albumin, C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) were performed. The main outcome was prolonged hospitalization, defined as a length of stay (LOS) greater than the cohort median of 8 days; postoperative complications were evaluated separately. Factors associated with prolonged hospitalization were analyzed using multiple logistic regression, and the model’s discrimination was assessed using receiver operating characteristic (ROC) analysis. Results: Overall, 93 patients (43.5%) experienced prolonged hospitalization. Patients who received NAC were hospitalized longer than those who didn’t (8.6 ± 2.9 days vs 7.2 ± 2.4 days; P = 0.001), and NAC patients also had more complications (28.4% vs 17.0%; P = 0.045). In the multivariable analysis, NAC exposure (OR = 1.82, 95% CI: 1.08–3.05; P = 0.024) and a higher NLR (OR = 1.36, 95% CI: 1.12–1.65; P = 0.002) were independently related to longer length of stay, while a greater level of albumin was negatively related to length of stay (OR = 0.94, 95% CI: 0.90–0.98; P = 0.006). The multivariable model had fair discrimination (AUC = 0.742, 95% CI: 0.676–0.808). Conclusions: Preoperative albumin and NLR levels may help identify patients at greater risk of prolonged hospitalization; further study is needed for multicenter validation.
SN - 1664-2392
ER -