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Annals of Surgical Oncology
Erschienen in: Annals of Surgical Oncology 5/2019

07.01.2019 | Breast Oncology

Local Recurrence of Benign, Borderline, and Malignant Phyllodes Tumors of the Breast: A Systematic Review and Meta-analysis

verfasst von: Yiwen Lu, MD, Yanbo Chen, MD, Liling Zhu, MD, Paul Cartwright, Erwei Song, MD, Lisa Jacobs, MD, Kai Chen, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 5/2019

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Abstract

Background

This systematic review and meta-analysis aimed to investigate local recurrence (LR) rates among the three grades (benign, borderline, and malignant) of phyllodes tumors (PTs). The study also assessed various risk factors for LR.

Methods

Electronic articles published between 1 January 1995 and 31 May 2018, were searched and critically appraised. The authors independently reviewed the abstracts and extracted data for LR rates and LR risk factors.

Results

The review incorporated 54 studies with 9234 individual cases. The pooled LR rates were 8% for benign, 13% for borderline, and 18% for malignant PTs. The risk of LR was significantly increased by borderline versus benign PTs (odds ratio [OR] 2.00; 95% confidence interval [CI] 1.68–2.38) and malignant versus borderline PTs (OR 1.28; 95% CI 1.05–1.55). The significant risk factors for LR were mitoses, tumor border (infiltrating vs. pushing), stromal cellularity (moderate/severe vs. mild), stromal atypia (severe vs. mild/absent), stromal overgrowth (severe vs. mild/absent), and tumor necrosis (positive vs. negative). Age and tumor size were not associated with LR risk. The subgroup analysis showed that breast-conserving surgery versus mastectomy and positive versus negative surgical margins were significantly associated with an increased LR risk only in malignant PTs.

Conclusions

The risk of LR was significantly increased from benign to borderline to malignant PTs. Mitoses, tumor border, stromal cellularity, stromal atypia, stromal overgrowth, tumor necrosis, type of surgery, and surgical margin status may be risk factors for LR. Different management strategies could be considered for different PT grades.
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Metadaten
Titel
Local Recurrence of Benign, Borderline, and Malignant Phyllodes Tumors of the Breast: A Systematic Review and Meta-analysis
verfasst von
Yiwen Lu, MD
Yanbo Chen, MD
Liling Zhu, MD
Paul Cartwright
Erwei Song, MD
Lisa Jacobs, MD
Kai Chen, MD
Publikationsdatum
07.01.2019
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 5/2019
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-07134-5

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