Olaya Justo, Sanjuan Juan, Luna Rina L, Casanova Lucia
Surgery - Mastology, Unidad Oncologica Surcolombiana, Neiva, COL.
Surgery - Mastology, Universidad Surcolombiana, Neiva, COL.
Cureus. 2020 May 4;12(5):e7951. doi: 10.7759/cureus.7951.
Introduction Phyllodes tumors (PTs) are uncommon fibroepithelial breast tumors that occur in middle-aged women, and they tend to vary in biologic behavior. Surgical management is the standard therapy for the condition, but factors associated with recurrence remain unclear. The aim of this study was to evaluate clinical and surgical characteristics related to PT recurrences. Methods This retrospective cohort study included patients in southern Colombia who were diagnosed with PT and managed at a level I teaching and referral hospital over a nine-year period. Factors associated with recurrence were determined by Cox regression analysis. Results This study included 61 patients; their median age was 46 years [interquartile range (IQR): 39-55 years]. Pathologically, 37 tumors (60.7%) were classified as low-grade. The median tumor size was 7 cm (IQR: 4-11.5 cm). Thirty-nine (63.9%) patients underwent quadrantectomy. Nine patients (14.8%) experienced tumor recurrence, with the median time to recurrence being one year (IQR: 0.5-2 years). Distant metastasis was observed in four patients (6.6%) at a median of nine months (IQR: 0.4-2.5 years). Univariate analyses showed that patients with high-grade tumors [hazard ratio (HR): 2.90, p = 0.148] and those who underwent mastectomy (HR: 2.90, p = 0.460) were at higher risk of recurrence. Conclusion PT recurrence may be associated with biological features, the extent of local excision, tumor size, and negative margins. However, multicenter data are needed to confirm these findings.
引言
叶状肿瘤(PTs)是发生于中年女性的罕见乳腺纤维上皮性肿瘤,其生物学行为往往存在差异。手术治疗是该病的标准疗法,但与复发相关的因素仍不明确。本研究旨在评估与PT复发相关的临床和手术特征。
方法
本回顾性队列研究纳入了哥伦比亚南部在一家一级教学和转诊医院接受诊治的PT患者,研究时间跨度为9年。通过Cox回归分析确定与复发相关的因素。
结果
本研究共纳入61例患者;中位年龄为46岁[四分位间距(IQR):39 - 55岁]。病理检查显示,37例肿瘤(60.7%)为低级别。肿瘤中位大小为7 cm(IQR:4 - 11.5 cm)。39例(63.9%)患者接受了象限切除术。9例患者(14.8%)出现肿瘤复发,复发的中位时间为1年(IQR:0.5 - 2年)。4例患者(6.6%)出现远处转移,中位时间为9个月(IQR:0.4 - 2.5年)。单因素分析显示,高级别肿瘤患者[风险比(HR):2.90,p = 0.148]和接受乳房切除术的患者(HR:2.90,p = 0.460)复发风险较高。
结论
PT复发可能与生物学特征、局部切除范围、肿瘤大小及切缘阴性有关。然而,需要多中心数据来证实这些发现。