Malignant Phyllodes Tumor

Abstract

The study aims to evaluate the survival and prognosis of patients with malignant phyllodes tumor. Between 1982 and 1998, 37 women with malignant phyllodes tumor were treated at the Regional Cancer Center, Trivandrum. Twelve patients were recurrent. Survival was estimated using the Kaplan-Meier method. Patient, disease, and treatment factors were compared using log-rank test. The Cox-proportional hazard model was employed to identify the prognostic factors. Thirty-six patients had surgery. Twenty-five patients received postoperative radiotherapy, and 2 received chemotherapy in addition. The median follow-up was 43 months (range 1-170 months). Eight patients failed locally, and 7 of these were successfully salvaged by surgery. The 5-year overall survival was 74.2% (95% CI, 0.44 to 0.89), whereas 5-year disease-free survival was 59.6% (95% CI, 0.39 to 0.7). The margin of surgical excision was found to be the only independent prognostic factor (p=0.003). However, patients with tumor size more than 5 cm (hazard ratio 2.9) were found to have increased hazard, whereas those receiving adjuvant radiotherapy (hazard ratio 0.6), married women (hazard ratio 0.4), and those women over the age of 35 years (hazard ratio 0.7) showed a decreased hazards. Cystosarcoma phyllodes is a rare malignancy of the female breast. Surgery with adequate margins is the primary treatment. Adjuvant radiotherapy appears to improve the disease-free survival.

Incidentally discovered extensive squamous metaplasia within borderline phyllodes tumor: presentation of a rare tumor

“…If the number of mitotic figures is less than 4/10 HPF PT is classified as benign, however if there are more than 10 mitoses/10 HPF, the tumor is considered having malignant potential. A borderline PT represents intermediate microscopic findings (9). In current case, 5-6/ HPF mitotic figures were counted, revealing a borderline subtype.…”

Transformación Osteosarcomatosa De Tumor Phyllodes Mamario

“…En tumores con diferenciación sarcomatosa sin evidencia de metástasis, la RT postquirúrgica parece aumentar la supervivencia libre de enfermedad en algunos estudios (3,5). Su apli-cación sistemática tras la excisión tumoral es controvertida, hay autores que defienden que el uso de RT adyuvante disminuye el riesgo de recidiva local (8), mejorando la supervivencia, mientras que otros grupos no justifican su uso cuando el margen es adecuado (1). Es una opción terapéutica a considerar en tumores grandes, recurrencias locales, sobrecrecimiento estromal o en caso de MTS (3).…”

Phyllodes tumor of the breast: Wolf inside the sheep’s skin!

“…[40] Similarly, Pandey et al reported that women over the age of 35 years showed a decreased HR (HR = 0.7). [44] However, a majority of the studies indicate advance age (>50 years) as the indicator of LR as well as survival. [30,31,45,46] This could be explained by the fact that the incidence of malignant histology increases with age.…”

“…In the series of Pandey et al from South India, 25 of 37 patients with a malignant PT who received postoperative RT had better 5-year DFS (61 vs. 25%) at a median follow-up of 43 months, but the difference was not statistically significant (p = 0.16). [44] However, patients with tumor size more than 5 cm (HR) = 2.9) were found to have increased hazard when analyzed for DFS.…”