Peng Y, Zhang Y Y, Wang S C, Wu J B, Tong F Z, Liu P, Cao Y M, Zhou B, Cheng L, Liu M, Liu H J, Guo J J, Xie F, Yang H P, Wang S Y, Wang C B, Wang S
Breast Center, Peking University People's Hospital, Beijing 100044, China.
Department of Pathology, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Wai Ke Za Zhi. 2021 Feb 1;59(2):116-120. doi: 10.3760/cma.j.cn112139-20201012-00748.
To examine treatment outcomes of breast phyllodes tumors and the prognosis factors of local recurrence. This retrospective cohort study included 276 patients who underwent surgical resection at Breast Center, Peking University People's Hospital from January 2011 to December 2019. Tumor subtype and histopathological features were determined from pathology reports, and the deadline of follow-up was September 30, 2020. All 276 patients underwent open surgery, including 17 patients of mastectomy, and 259 patients of lumpectomy. The enrolled patients were all female, with age of (41.5±11.3) years (rang: 11 to 76 years), and tumor diameter of 35(28) mm (()). The Kaplan-Meier method and Log-rank test were used for survival analysis. The multivariate analysis was implemented using the Cox proportional hazard model. According the pathologic test, there were 191 patients of benign phyllodes tumor, 67 patients of borderline tumor and 18 patients of malignant tumor. There were 249 patients with a follow-up of more than 6 months, and 14.1% (35/249) had local recurrence. The time-to-recurrence was (28.6±22.2) months (range: 2 to 96 months), (29.1±18.1) months (range: 2 to 80 months), (32.1±30.1) months (range: 5 to 96 months) and (12.0±6.9) months (range: 8 to 20 months) for benign, borderline and malignant phyllodes tumors. Tumor diameter (≥100 mm <50 mm, =3.968, 95%CI: 1.550 to 10.158, =0.004) and malignant heterologous element (yes no, =26.933, 95%CI: 3.105 to 233.600, =0.003) were prognosis factors of local recurrence. One death from malignant phyllodes occurred after distant metastasis. The 3-year disease-free survival rates of benign, borderline and malignant phyllodes tumor were 88.2%, 81.7% and 81.4% (=0.300). Phyllodes tumors have a considerable local recurrence rate, which may be associated with tumor diameter and malignant heterologous element.
探讨乳腺叶状肿瘤的治疗效果及局部复发的预后因素。本回顾性队列研究纳入了2011年1月至2019年12月在北京大学人民医院乳腺中心接受手术切除的276例患者。根据病理报告确定肿瘤亚型和组织病理学特征,随访截止日期为2020年9月30日。276例患者均接受了开放手术,其中17例行乳房切除术,259例行肿块切除术。纳入患者均为女性,年龄(41.5±11.3)岁(范围:11至76岁),肿瘤直径35(28)mm(())。采用Kaplan-Meier法和Log-rank检验进行生存分析。多因素分析采用Cox比例风险模型。根据病理检查,良性叶状肿瘤191例,交界性肿瘤67例,恶性肿瘤18例。249例患者随访时间超过6个月,14.1%(35/249)发生局部复发。良性、交界性和恶性叶状肿瘤的复发时间分别为(28.6±22.2)个月(范围:2至96个月)、(29.1±18.1)个月(范围:2至80个月)、(32.1±30.1)个月(范围:5至96个月)和(12.0±6.9)个月(范围:8至20个月)。肿瘤直径(≥100 mm <50 mm,=3.968,95%CI:1.550至10.158,=0.004)和恶性异源性成分(是 否,=26.933,95%CI:3.105至233.600,=0.003)是局部复发的预后因素。1例恶性叶状肿瘤患者远处转移后死亡。良性、交界性和恶性叶状肿瘤的3年无病生存率分别为88.2%、81.7%和81.4%(=0.300)。叶状肿瘤有相当高的局部复发率,这可能与肿瘤直径和恶性异源性成分有关。