Prognostic factors in breast phyllodes tumors: a nomogram based on a retrospective cohort study of 404 patients

Abstract

The aim of this study was to explore the independent prognostic factors related to postoperative recurrence‐free survival (RFS) in patients with breast phyllodes tumors (PTBs). A retrospective analysis was conducted in Fudan University Shanghai Cancer Center. According to histological type, patients with benign PTBs were classified as a low‐risk group, while borderline and malignant PTBs were classified as a high‐risk group. The Cox regression model was adopted to identify factors affecting postoperative RFS in the two groups, and a nomogram was generated to predict recurrence‐free survival at 1, 3, and 5 years. Among the 404 patients, 168 (41.6%) patients had benign PTB, 184 (45.5%) had borderline PTB, and 52 (12.9%) had malignant PTB. Fifty‐five patients experienced postoperative local recurrence, including six benign cases, 26 borderline cases, and 22 malignant cases; the three histological types of PTB had local recurrence rates of 3.6%, 14.1%, and 42.3%, respectively. Stromal cell atypia was an independent prognostic factor for RFS in the low‐risk group, while the surgical approach and tumor border were independent prognostic factors for RFS in the high‐risk group, and patients receiving simple excision with an infiltrative tumor border had a higher recurrence rate. A nomogram developed based on clinicopathologic features and surgical approaches could predict recurrence‐free survival at 1, 3, and 5 years. For high‐risk patients, this predictive nomogram based on tumor border, tumor residue, mitotic activity, degree of stromal cell hyperplasia, and atypia can be applied for patient counseling and clinical management. The efficacy of adjuvant radiotherapy remains uncertain.

Risk Factors for Disease Recurrence in Women With Phyllodes Tumors of the Breast in Southern Colombia: A Nine-Year Cohort Study

“…The medical histories of all patients were assessed to determine disease recurrence rates. Similar to previous reports, we found that the recurrence rate was 14.8%, and the mortality rate was 6.6% [2,3,5,8].…”

“…Compromised resection margins have also been linked to local and distant recurrence [14][15][16][17]. However, these rates were lower in our study than in previous reports [2,3,8]. Indeed, only one patient in the present study had compromised resection margins, and this patient experienced a local recurrence.…”

“…Also, adjuvant radiotherapy is recommended under the principles for treating soft-tissue sarcomas [6,7]. Features of PTs associated with disease recurrence remain unclear [8]. The present study was designed to assess the relationships between tumor recurrence and the clinical and surgical characteristics of patients diagnosed with PT who were treated in southern Colombia over a nine-year period.…”

Borderline and Malignant Phyllodes Tumors: How Often do They Locally Recur and is There Anything we can do About it?

“…In 2009, the results of 13 studies were summarized: 12/50 patients (24%) with borderline PTs and 25/124 patients (20%) with malignant PTs locally recurred after margin-negative BCS. 2 [3][4][5][6][7] Combining these results with the 13 previous studies identified 140 LRs in 685 patients, a 20.4% LR rate in patients with borderline or malignant PTs undergoing BCS with negative margins.…”

Nomogram predicted overall survival of patients with neuroendocrine carcinoma of the breast

“…First, our aim is to assess the prognostic value of clinicopathological characteristics in NEBC patients. Secondly, we designed to establish a predictive nomogram which has been wildly used in many other cancer diseases to accomplish overall survival estimation for NEBC patients [21][22][23][24][25][26][27]. Finally, we aimed to evaluate the clinical applicability of the nomogram in predicting prognosis.…”