Li Yiwen, Chen Heyan, Qu Fengjiang, Qu Xiaoying, Zhang Qihe, Feng Kexuan, Li Xiaoduo, Zhang Huimin, Fan Zhimin
Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin, China.
Department of Breast Cancer, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Front Oncol. 2025 May 26;15:1538523. doi: 10.3389/fonc.2025.1538523. eCollection 2025.
To clarify the risk factors of phyllodes tumor (PT) for local recurrence (LR).
Data from 829 patients with pathologically confirmed benign, borderline and malignant PT of the breast, diagnosed from between 2011 to 2023, were retrieved from the electronic databases of the First Hospital of Jilin University and the First Affiliated Hospital of Xi'an Jiaotong University. Kaplan-Meier curves and Cox proportional-hazards model were conducted to determine the independent risk factors for LR in each group.
Of 829 PT patients, 634 (76.5%), 142 (17.1%), and 53 (6.4%) were diagnosed with benign, borderline, and malignant PT, respectively. The LR rates were 5.4%, 9.9%, 13.2%, respectively. The median patient age was 38 years and the median follow-up time was 2.8 (range, 0.2-12.1 years). Of these patients, 13 (2.1%) were diagnosed with benign bilateral PT. Multivariate analysis identified bilateral involvement as a risk factor for LR of benign PT (=0.010). Also, univariate analysis identified young age (≤35 years, =0.046) as an independent risk factors for LR of borderline PT. Of the patients with malignant PT, univariate analysis found that breast-conserving surgery (BCS) (=0.008) were associated with an increased risk for LR of malignant PT.
Bilateral PT was a risk factor for LR of benign PT, young age (≤35 years) was associated with poor prognosis of borderline PT, BCS were high risk factors for LR of malignant PT. This study identifies LR risk factors based on tumor grading, which contributes to individualized clinical risk assessment. Future research could further explore how to incorporate these factors into clinical decision-making models for PT and other soft tissue tumors.
明确叶状肿瘤（PT）局部复发（LR）的危险因素。
从吉林大学第一医院和西安交通大学第一附属医院的电子数据库中检索2011年至2023年期间诊断为乳腺病理确诊的良性、交界性和恶性PT的829例患者的数据。采用Kaplan-Meier曲线和Cox比例风险模型确定每组LR的独立危险因素。
829例PT患者中，分别有634例（76.5%）、142例（17.1%）和53例（6.4%）被诊断为良性、交界性和恶性PT。LR率分别为5.4%、9.9%、13.2%。患者中位年龄为38岁，中位随访时间为2.8年（范围0.2 - 12.1年）。其中，13例（2.1%）被诊断为良性双侧PT。多因素分析确定双侧受累是良性PT发生LR的危险因素（P = 0.010）。此外，单因素分析确定年轻（≤35岁，P = 0.046）是交界性PT发生LR的独立危险因素。在恶性PT患者中，单因素分析发现保乳手术（BCS，P = 0.008）与恶性PT发生LR的风险增加相关。
双侧PT是良性PT发生LR的危险因素，年轻（≤35岁）与交界性PT预后不良相关，BCS是恶性PT发生LR的高危因素。本研究基于肿瘤分级确定了LR危险因素，有助于进行个体化临床风险评估。未来研究可进一步探索如何将这些因素纳入PT及其他软组织肿瘤的临床决策模型。
