Wen Zhao1, Qi Tian1, Andi Zhao1, Biyuan Wang1, Jiao Yang1, Le Wang1, Lingxiao Zhang1, Danfeng Dong1, Ling Chen1, Jin Yang2. 1. Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China. 2. Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, No 277 Yanta West Road, Xi'an, 710061, Shaanxi, People's Republic of China. 1473106133@qq.com.
Abstract
BACKGROUND AND OBJECTIVES: Malignant phyllodes tumor of the breast (MPTB) is a kind of rare tumor. Our objective was to investigate the role of adjuvant radiotherapy (RT) in MPTB patients. METHODS: MPTB patients were identified in the Surveillance, Epidemiology and End Results (SEER) database. Kaplan-Meier curves and multivariable Cox proportional hazards analyses were conducted to determine the effect of adjuvant RT on MPTB patients. Propensity-score matching (PSM) method was used to balance the clinicopathological characteristics. RESULTS: A total of 1353 MPTB patients were included in our study and the median follow-up time was 99 months (range: 0-331 months). 16.7% (226) MPTB patients received adjuvant RT, of which 49.1% (111) received mastectomy and 50.9% (115) underwent breast conservation surgery (BCS). Patients receiving adjuvant RT were more likely to be white, with better differentiation and larger tumors (p < 0.05). Multivariate analysis showed that poorer tumor differentiation grade, larger tumor size, and lymph node metastasis were associated with reduced survival while BCS was a protective factor of disease-specific survival (DSS) (HR 0.297; 95% CI 0.184-0.480) and overall survival (OS) (HR 0.445; 95% CI 0.321-0.616). After PSM, survival curves showed patients did not achieve an improved OS or DSS from adjuvant RT (p > 0.05). In subgroup analysis, no subgroup benefited from adjuvant RT. Exploratory analysis showed a survival benefit trend from adjuvant RT in patients with tumor larger than 50 mm and undergoing BCS. CONCLUSIONS: Among MPTB patients, adjuvant RT did not improve OS or DSS. In patients with tumor larger than 50 mm and receiving BCS, a survival benefit trend from adjuvant RT existed.
BACKGROUND AND OBJECTIVES: Malignant phyllodestumor of the breast (MPTB) is a kind of rare tumor. Our objective was to investigate the role of adjuvant radiotherapy (RT) in MPTBpatients. METHODS:MPTBpatients were identified in the Surveillance, Epidemiology and End Results (SEER) database. Kaplan-Meier curves and multivariable Cox proportional hazards analyses were conducted to determine the effect of adjuvant RT on MPTBpatients. Propensity-score matching (PSM) method was used to balance the clinicopathological characteristics. RESULTS: A total of 1353 MPTBpatients were included in our study and the median follow-up time was 99 months (range: 0-331 months). 16.7% (226) MPTBpatients received adjuvant RT, of which 49.1% (111) received mastectomy and 50.9% (115) underwent breast conservation surgery (BCS). Patients receiving adjuvant RT were more likely to be white, with better differentiation and larger tumors (p < 0.05). Multivariate analysis showed that poorer tumor differentiation grade, larger tumor size, and lymph node metastasis were associated with reduced survival while BCS was a protective factor of disease-specific survival (DSS) (HR 0.297; 95% CI 0.184-0.480) and overall survival (OS) (HR 0.445; 95% CI 0.321-0.616). After PSM, survival curves showed patients did not achieve an improved OS or DSS from adjuvant RT (p > 0.05). In subgroup analysis, no subgroup benefited from adjuvant RT. Exploratory analysis showed a survival benefit trend from adjuvant RT in patients with tumor larger than 50 mm and undergoing BCS. CONCLUSIONS: Among MPTBpatients, adjuvant RT did not improve OS or DSS. In patients with tumor larger than 50 mm and receiving BCS, a survival benefit trend from adjuvant RT existed.
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