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Re-excision or “wait and watch”—a prediction model in breast phyllodes tumors after surgery
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 pati...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186749/ https://www.ncbi.nlm.nih.gov/pubmed/32355815 http://dx.doi.org/10.21037/atm.2020.02.26 |
Sumario: | 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”. |
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