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Meta-Analysis
. 2022 Nov:107:106969.
doi: 10.1016/j.ijsu.2022.106969. Epub 2022 Oct 31.

Management of phyllodes tumor: A systematic review and meta-analysis of real-world evidence

Chia-Yun Yu  1 , Tsai-Wei Huang, Ka-Wai Tam
Affiliations
Meta-Analysis

Management of phyllodes tumor: A systematic review and meta-analysis of real-world evidence

Chia-Yun Yu et al. Int J Surg. 2022 Nov.

Abstract

Background: Phyllodes tumor is rare but has a high recurrence rate. Treatment modalities and clinicopathological prognostic factors for recurrence remain unclear. The synthesis of real-world data can enable the integration of sufficient evidence on optimal treatment for this population.

Methods: We searched PubMed, Embase, and Cochrane Library databases for studies focusing on the management of phyllodes tumor including the surgical margin, different clinicopathological prognostic factors, and postoperative adjuvant radiotherapy versus no radiotherapy.

Results: Fifty-two studies were retrieved. The pooled estimated recurrence rates of benign, borderline, and malignant tumors were 7.1%, 16.7%, and 25.1%, respectively. Surgical margins of 1 mm (odds ratio [OR]: 0.4, 95% confidence interval [CI]: 0.27-0.61) and 1 cm (OR: 0.45, 95% CI: 0.15-0.85) resulted in significantly higher recurrence rates. Postoperative adjuvant radiotherapy significantly reduced the recurrence rate of malignant tumors relative to no radiotherapy (P = 0.034) but did not significantly reduce the recurrence rates of overall and borderline tumors. Regarding clinicopathological features, moderate or severe stromal atypia and hypercellularity, stromal overgrowth, mitotic number of 5, tumor necrosis, tumor border, and margin status were determined as independent prognostic factors for recurrence, except a tumor size of 5 cm.

Conclusion: The ideal surgical margin for phyllodes tumor incision should be at least 1 cm in width. Adjuvant radiotherapy reduced the recurrence of malignant tumor. By identifying patients with poor clinicopathological risk factors, surgeons may reduce the recurrence rate of phyllodes tumor.

Keywords: Adjuvant radiotherapy; Clinicopathological prognosis factors; Phyllodes tumor; Recurrence rate; Surgical margin.

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Conflict of interest statement

Declaration of competing interest The authors Chia-Yun Yu, Tsai-Wei Huang, and Ka-Wai Tam confirm that there are no known conflicts of interest associated with this publication “Management of Phyllodes Tumor: A Systematic Review and Meta-Analysis of Real-World Evidence".

References

    1. Gnerlich JL, Williams RT, Yao K, Jaskowiak N, Kulkarni SA. Utilization of radiotherapy for malignant phyllodes tumors: analysis of the National Cancer Data Base, 1998-2009. Ann. Surg Oncol. 2014;21(4):1222-1230.
    1. Guillot E, Guillot E, Reyal F, Curnier A, Ravinet J, Laé M, et al. Management of phyllodes breast tumors. Breast J. 2011;17(2):129-137.
    1. Parker SJ, Harries SA. Phyllodes tumours. Postgrad. Med. 2001;77:428-435.
    1. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology, Breast Cancer, version 5.2020. [Updated: Jul 2020; Accessed: Jan 2022].
    1. Chaney AW, Pollack A, McNeese MD, Zagars GK, Pisters PW, Pollock RE, et al. Primary treatment of cystosarcoma phyllodes of the breast. Cancer. 2000;89(7):1502-1511.

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