Time to revise classification of phyllodes tumors of breast? Results of a French multicentric study
| Autor: | Geoffroy Canlorbe, Sofiane Bendifallah, Marie-José Adam, Asma Mahmood, Vincent Lavoué, Camille Cohen-Steiner, Jean Levêque, Guillaume Legendre, Emile Daraï, Lobna Ouldamer, Laetitia Ropars, Marcos Ballester, Adolphe Der Some, Krystel Nyangoh Timoh, Négar Kalhorpour, Chloé Rousseau |
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| Přispěvatelé: | CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES) |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Surgical margin Multivariate analysis Breast surgery medicine.medical_treatment [SDV]Life Sciences [q-bio] Breast Neoplasms Prognostic factors World health Hospitals University 03 medical and health sciences 0302 clinical medicine Phyllodes Tumor Internal medicine medicine Borderline Humans 030212 general & internal medicine Univariate analysis Malignant business.industry Margins of Excision General Medicine Middle Aged Prognosis University hospital 3. Good health Phyllodes breast tumor Oncology Pleomorphism (cytology) Benign 030220 oncology & carcinogenesis Female Surgery France Neoplasm Grading Neoplasm Recurrence Local business Cohort study |
| Zdroj: | EJSO-European Journal of Surgical Oncology EJSO-European Journal of Surgical Oncology, 2018, 44 (11), pp.1743-1749. ⟨10.1016/j.ejso.2018.08.007⟩ EJSO-European Journal of Surgical Oncology, WB Saunders, 2018, 44 (11), pp.1743-1749. ⟨10.1016/j.ejso.2018.08.007⟩ |
| ISSN: | 0748-7983 |
| DOI: | 10.1016/j.ejso.2018.08.007⟩ |
| Popis: | International audience; Objective - To assess prognostic factors of recurrence of phyllodes tumors (PT) of the breast. Methods - We performed a retrospective, multicentric cohort study, including all patients who underwent breast surgery for grade 1 (benign), 2 (borderline) or 3 (malignant) PT between 2000 and 2016 in five tertiary University hospitals, diagnosed according to World Health Organisation classification. Results - 230 patients were included: 144 (63%), 60 (26%) and 26 (11%) with grade 1, 2 and 3 PT, respectively. Recurrence occurred in 10 (7%), 7 (12%) and 5 (19%) patients with grade 1, 2 and 3 PT, respectively. In univariate analysis, moderate to severe nuclear stromal pleomorphism (HR 8.00 [95% CI: 1.65-38.73], p 5 mm, (HR 0.20 [95% CI: 0.06-0.63], p = 0.013) were significantly correlated with less recurrence in all PT grades. For grade 1 PT, there was also significantly less recurrence with surgical margin >5 mm, (HR 0.09 [95% CI: 0.01-0.85], p = 0.047) in multivariate analysis. Conclusion - The surgical margin should be at least 5 mm whatever the grade of PT. Moderate to severe nuclear stromal pleomorphism identified a subgroup of grade 1 PT with a higher rate of recurrence. This suggests that the WHO classification could be revised with the introduction of nuclear stromal pleomorphism to tailor PT management. |
| Databáze: | OpenAIRE |
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