Park Hae Jin, Ryu Han Suk, Kim Kyubo, Shin Kyung Hwan, Han Wonshik, Noh Dong-Young
Department of Radiation Oncology, Hanyang University College of Medicine, Seoul, Republic of Korea.
Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea.
In Vivo. 2019 Jan-Feb;33(1):263-269. doi: 10.21873/invivo.11470.
BACKGROUND/AIM: In this study, the treatment outcome and risk factors for recurrence in patients undergoing surgery with or without adjuvant radiotherapy (RT) for malignant phyllodes tumors of the breast (MPTB) were analyzed.
Forty-three patients (61.4%) underwent breast-conserving surgery (BCS) and 27 (38.6%) underwent mastectomy. Fifteen patients (21.4%) received adjuvant RT.
With a median follow-up of 76 months, the 7-year local control (LC), distant metastasis-free survival (DMFS), disease-free survival (DFS), and cause-specific survival (CSS) rates were 90.7%, 85.2%, 80.3%, and 87.1%, respectively. Either the extent of surgery or treatment with adjuvant RT did not affect the outcomes. On multivariate analysis, the presence of tumor necrosis was associated with inferior DFS (p=0.017), while infiltrative tumor border showed a marginal significance (p=0.078). When stratified using these two adverse pathological features, the 7-year DFS rates were 100%, 54.9%, and 55.6% in patients with 0, 1, and 2 risk factors, respectively (p=0.002).
MPTB patients undergoing surgery with or without adjuvant RT had a favorable outcome. Although there was no local recurrence in patients treated with adjuvant RT, the effect of adjuvant RT failed to reach a statistical significance. Risk-grouping based on pathological features might help design a clinical trial for MPTB.
背景/目的：本研究分析了接受或未接受辅助放疗（RT）的乳腺恶性叶状肿瘤（MPTB）手术患者的治疗结果及复发风险因素。
43例患者（61.4%）接受了保乳手术（BCS），27例（38.6%）接受了乳房切除术。15例患者（21.4%）接受了辅助放疗。
中位随访76个月，7年局部控制（LC）、无远处转移生存（DMFS）、无病生存（DFS）和特定病因生存（CSS）率分别为90.7%、85.2%、80.3%和87.1%。手术范围或辅助放疗均未影响治疗结果。多因素分析显示，肿瘤坏死与较差的DFS相关（p=0.017），而浸润性肿瘤边界具有边缘显著性（p=0.078）。根据这两个不良病理特征进行分层时，0、1和2个风险因素患者的7年DFS率分别为100%、54.9%和55.6%（p=0.002）。
接受或未接受辅助放疗的MPTB手术患者预后良好。虽然接受辅助放疗的患者无局部复发，但辅助放疗的效果未达到统计学显著性。基于病理特征的风险分组可能有助于设计MPTB的临床试验。
