Han Mengjia, Zhang Yunyi, Lei Rong, Lai Zijia, Zhuang Zilin, Zhang Yulu, Li Xun, Li Xiaojun, Jia Rurong, Jiang Qiongchao, Ye Feng, Nie Yan
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, Guangdong, China; Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, Guangdong, China.
Department of Breast Surgery, Third Hospital of Nanchang, Nanchang, 330009, JiangXi, China.
Breast. 2025 Jun;81:104455. doi: 10.1016/j.breast.2025.104455. Epub 2025 Mar 19.
The aim of this study is to contribute a better understanding of metastatic malignant phyllode tumors (MMPTs) by exploring its prognostic factors, describing treatment landscape, and providing optimal treatment choices.
This retrospective multicentric study was included 43 patients with MMPTs who received treatment from 2009 to 2023 in four centers. The primary endpoint of the study was overall survival (OS).
The median overall survival of these patients was 7.27 months (range: 0.63-118.53) and the median follow-up time was 16.8 months (range: 2-188). The median age of these patients were 49 years. The median metastasis-free survival (MFS, it is the time between initial diagnosis and diagnosis of metastatic disease) was 7.27 months, and the most common site of metastasis was lung (35/43, 81.4 %). Treatment for MMPTs primarily consisted of systemic chemotherapy and metastasectomy. Multivariate analysis revealed that chemotherapy after metastasis (HR = 0.250, 95 % CI 0.109-0.571; P = 0.001) and MFS >6 months (HR = 0.407, 95 % CI 0.198-0.836; P = 0.014) were independently associated with OS. The most common chemotherapy regimen was anthracyclines along with ifosfamide (AI), with the median progression-free survival of 5.5 months. Metastasectomy did not significantly improve OS.
The study findings highlight the significance of systemic treatment (chemotherapy) and the impact of MFS on prognosis of MMPTs. For these patients, systemic treatment may improve survival outcomes. And patients with MFS <6 months appear to have a poorer prognosis.
本研究旨在通过探索转移性恶性叶状肿瘤（MMPTs）的预后因素、描述治疗情况并提供最佳治疗选择，以增进对该疾病的了解。
这项回顾性多中心研究纳入了2009年至2023年期间在四个中心接受治疗的43例MMPTs患者。研究的主要终点是总生存期（OS）。
这些患者的中位总生存期为7.27个月（范围：0.63 - 118.53个月），中位随访时间为16.8个月（范围：2 - 188个月）。这些患者的中位年龄为49岁。中位无转移生存期（MFS，即从初始诊断到转移疾病诊断之间的时间）为7.27个月，最常见的转移部位是肺（35/43，81.4%）。MMPTs的治疗主要包括全身化疗和转移灶切除术。多变量分析显示，转移后化疗（HR = 0.250，95%CI 0.109 - 0.571；P = 0.001）和MFS>6个月（HR = 0.407，95%CI 0.198 - 0.836；P = 0.014）与OS独立相关。最常见的化疗方案是蒽环类药物联合异环磷酰胺（AI），中位无进展生存期为5.5个月。转移灶切除术并未显著改善OS。
研究结果突出了全身治疗（化疗）的重要性以及MFS对MMPTs预后的影响。对于这些患者，全身治疗可能改善生存结果。MFS<6个月的患者预后似乎较差。
