Hu Qun-Chao, Mei Xin, Feng Yan, Ma Jin-Li, Yang Zhao-Zhi, Shao Zhi-Min, Yu Xiao-Li, Guo Xiao-Mao
From the Department of Radiation Oncology (QH, XM, YF, JM, ZY, XY, XG); Department of Breast Surgery (ZS), Fudan University Shanghai Cancer Center; Department of Oncology, (QH, XM, YF, JM, ZY, ZS, XY, XG); Shanghai Medical College, Fudan University, Shanghai, China; and Suzhou Municipal Hospital, Suzhou, China (QH).
Medicine (Baltimore). 2016 Jan;95(1):e2422. doi: 10.1097/MD.0000000000002422.
Primary breast sarcomas (PBSs) are spectrum heterogeneous sarcomas in breast and the optimal treatment for them is still under discussion. Our study was to investigate clinical characteristics and identify potential prognostic factors for this rare malignancy. The authors retrospectively reviewed 38 patients with PBSs between October 2000 and February 2014 in FuDan University Shanghai Cancer Center. Local control rate and overall survival (OS) were determined by Kaplan-Meier actuarial method. Univariate analysis and Cox proportional hazards model were applied to identify potential prognostic factors. With median follow-up of 40.19 months, 14 patients (14/38) were found with local recurrence. Extensive operation like mastectomy was not superior to local resection (P = 0.167). Three-year recurrence-free survival and OS rate were 61.9% and 89%, respectively. Larger tumor size and local recurrence were indicated as unfavorable prognostic factors in univariate analysis. Cox model identified narrow interval of recurrence free survival as an unfavorable factor (P = 0.048). Surgery remains crucial treatment for PBSs. Mastectomy, however, is not routinely necessary if clear margin could be achieved by local excision. Early recurrence indicates a poor OS.
原发性乳腺肉瘤（PBSs）是乳腺中具有光谱异质性的肉瘤，其最佳治疗方案仍在讨论中。我们的研究旨在调查其临床特征并确定这种罕见恶性肿瘤的潜在预后因素。作者回顾性分析了2000年10月至2014年2月间复旦大学附属肿瘤医院收治的38例原发性乳腺肉瘤患者的资料。采用Kaplan-Meier法计算局部控制率和总生存率（OS）。采用单因素分析和Cox比例风险模型确定潜在的预后因素。中位随访时间为40.19个月，14例（14/38）患者出现局部复发。乳房切除术等广泛手术并不优于局部切除术（P = 0.167）。三年无复发生存率和总生存率分别为61.9%和89%。单因素分析表明，肿瘤体积较大和局部复发是不良预后因素。Cox模型确定无复发生存间隔时间短是一个不良因素（P = 0.048）。手术仍然是原发性乳腺肉瘤的关键治疗方法。然而，如果局部切除能够达到切缘阴性，则不一定需要常规进行乳房切除术。早期复发提示总生存率较差。
