| Title | Re-excision or "wait and watch"-a prediction model in breast phyllodes tumors after surgery |
| Authors | Chao, Xue Jin, Xiaoyan Tan, Cui Sun, Peng Cui, Junwei Hu, Hui Ouyang, Qian Chen, Kai Wu, Wei He, Zhanghai Nie, Yan Yao, Herui |
| Affiliation | Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Guangdong Prov Key Lab Malignant Tumor Epigenet &, Guangzhou 510120, Peoples R China Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Breast Tumor Ctr, 107 Yanjiang West Rd, Guangzhou 510120, Peoples R China Sun Yat Sen Univ, Canc Ctr, Pathol Dept, Guangzhou 510000, Peoples R China Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Gen Dept, Guangzhou 510120, Peoples R China Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Pathol Dept, Guangzhou 510120, Peoples R China Peking Univ, Shenzhen Hosp, Dept Breast Surg, Shenzhen 518036, Peoples R China |
| Keywords | LOCAL RECURRENCE SURGICAL EXCISION FEATURES BENIGN SURVIVAL RADIOTHERAPY DISTINCTION MANAGEMENT PROGNOSIS NOMOGRAM |
| Issue Date | Mar-2020 |
| Publisher | ANNALS OF TRANSLATIONAL MEDICINE |
| Abstract | Background: The prognosis of breast phyllodes tumors (PTs) largely depending on the pathological grading, which lacks objectivity. This study aimed to develop a nomogram based on clinicopathological features to evaluate the recurrence probability of PTs following surgery. Methods: Data from 334 patients with breast PTs, who underwent surgical treatment at Sun Yat-sen Memorial Hospital from January 2005 to December 2014, were used to develop a prediction model. Additionally, data of 36 patients from Peking University Shenzhen Hospital (cohort 1) and data of 140 patients from Sun Yat-sen University Cancer Center (cohort 2) during the same period were used to validate the model. The medical records and tumor slides were retrospectively reviewed. The log-rank and Cox regression tests were used to develop a clinical prediction model of breast PTs. All statistical analyses were performed using R and STATA. Results: Of all 334 patients included in the primary cohort, 224 had benign, 91 had borderline, and 19 had malignant tumors. The 1-, 3-, and 5-year recurrence-free survival was 98.5%, 97.9%, and 96.8%, respectively. Ultrasound-guided vacuum-assisted biopsy (UGVAB) is a non-inferior treatment application in benign PTs compared with open surgery [hazard ratio (HR), 2.38; 95% confidence interval (CI), 0.59-9.58]. Width of surgical margin, mitoses, and tumor border were identified as independent risk factors for breast PTs. A nomogram was developed based on these three variables. The C-index of internal and external validation was 0.71, 0.67 (cohort 1) and 0.73 (cohort 2), respectively. Conclusions: The study model presented more concise and objective variables to evaluate the recurrence-free survival of patients after surgery, which can help deciding whether to do a re-excision or "wait and watch". |
| URI | http://hdl.handle.net/20.500.11897/587501 |
| ISSN | 2305-5839 |
| DOI | 10.21037/atm.2020.02.26 |
| Indexed | SCI(E) |
| Appears in Collections: | 深圳医院 |
