by Yang Li, Yixuan Song, Ronggang Lang, Lu Shi, Shuang Gao,
Hong Liu, Ping Wang
The Breast: VOLUME 57, P62-70, JUNE
01, 2021 (Published: March 16, 2021)
Purpose
The potential recurrence rate of malignant phyllodes tumors
(MPTs) of the breast is high, and the prognostic factors are still unclear. We
therefore aim to study the factors affecting the outcome of MPTs.
Methods
A retrospective review of MPT patients treated from 2006 to
2020 at our institution was conducted. Univariate and multivariate Cox
proportional hazard models were used to examine the influence of different
variables on RFS. Moreover, significant prognostic factors were combined to
construct the nomogram to predict the probability of relapse occurring in MPT
patients. The 5-year and 10-year RFS rates were estimated using the
Kaplan–Meier method.
Results
During the study period, 188 MPT patients were identified.
The presence of malignant heterologous elements was observed in 23 (12.2%)
patients with MPT, and the patients with malignant heterologous elements who
received chemotherapy had longer RFS, which could reduce the risk of recurrence
(p = 0.022). Recurrence occurred in 56/188 (29.8%) patients, of whom
47 experienced local recurrence and 11 experienced distant metastases. The
5-year and 10-year cumulative RFS rates were 77.5% and 70.1%, respectively. Age
(p = 0.041), fibroadenoma surgery history (p = 0.004),
surgical margins (p = 0.001) and malignant heterologous elements
(p < 0.001) were independent risk factors for postoperative RFS.
Subsequently, a nomogram was built, with a C-index of 0.64 (95% CI:
0.629–0.661), to predict the risk of recurrence.
Conclusion
The results of this study showed that younger age,
fibroadenoma surgery history, malignant heterologous elements and surgical
margins <1 cm predict a higher incidence of recurrence in MPT patients.
Patients with malignant heterologous elements treated with chemotherapy could
have a reduced risk of recurrence.
