Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China.
Department of Respiratory and Critical Care Medicine, Division of Life Science and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.
Updates Surg. 2024 Jan;76(1):265-270. doi: 10.1007/s13304-023-01547-y. Epub 2023 Jun 8.
Malignant phyllodes tumor of the breast (MPTB) is a rare type of breast cancer. The prognosis between breast-conserving surgery (BCS) and mastectomy remains unclear in MPTB. Therefore, long-term survival was investigated between BCS and mastectomy in MPTB via the Surveillance, Epidemiology, and End Results (SEER) database. MPTB patients with T1-2/N0 stage between 2000 and 2015 from SEER database were retrospectively reviewed. Prognosis between different surgical approaches was assessed by Kaplan-Meier curves and Cox proportional hazards analysis. A total of 795 patients were enrolled with a median follow-up of 126 months. BCS was associated with significantly increased 10-year overall survival (OS) (89.2% vs. 81.1%, p = 0.002) and breast cancer-specific survival (BCSS) (95.2% vs. 90%, p = 0.004) compared with mastectomy. Multivariate analysis showed better OS (HR = 0.587, 95% CI 0.406-0.850, p = 0.005) and BCSS (HR = 0.463, 95%CI 0.267-0.804, p = 0.006) in the BCS group than the mastectomy group. After 1:1 propensity score matching (PSM), improved 10-year OS (89.2% vs.81%, p = 0.023) and BCSS (95.8% vs. 90.1%, p = 0.033) were observed in BCS compared with mastectomy. This study found the survival benefit of BCS over mastectomy in patients with early-stage MPTB. BCS should be recommended as a priority in MPTB patients when both surgical approaches are feasible.
乳腺恶性叶状肿瘤（MPTB）是一种罕见的乳腺癌。保乳手术（BCS）和乳房切除术之间的预后在 MPTB 中仍不清楚。因此，本研究通过监测、流行病学和最终结果（SEER）数据库调查了 BCS 和乳房切除术之间 MPTB 的长期生存情况。回顾性分析了 SEER 数据库中 2000 年至 2015 年 T1-2/N0 期 MPTB 患者。通过 Kaplan-Meier 曲线和 Cox 比例风险分析评估不同手术方式的预后。共纳入 795 例患者，中位随访 126 个月。与乳房切除术相比，BCS 显著提高了 10 年总生存率（OS）（89.2% vs. 81.1%，p=0.002）和乳腺癌特异性生存率（BCSS）（95.2% vs. 90%，p=0.004）。多变量分析显示，BCS 组的 OS（HR=0.587，95%CI 0.406-0.850，p=0.005）和 BCSS（HR=0.463，95%CI 0.267-0.804，p=0.006）均优于乳房切除术组。在 1:1 倾向评分匹配（PSM）后，BCS 组与乳房切除术组相比，10 年 OS（89.2% vs.81%，p=0.023）和 BCSS（95.8% vs. 90.1%，p=0.033）均得到改善。本研究发现，BCS 在早期 MPTB 患者中优于乳房切除术。当两种手术方法都可行时，BCS 应被推荐为 MPTB 患者的首选。
