Titre :

Surgical Margins and Adjuvant Therapies in Malignant Phyllodes Tumors of the Breast: A Multicenter Retrospective Study.

Auteur(s) :

Neron, Mathias [Auteur]

Sajous, Christophe [Auteur]
Centre Léon Bérard [Lyon]
Thezenas, Simon [Auteur]

Piperno-Neumann, Sophie [Auteur]
Institut Curie [Paris]
Reyal, Fabien [Auteur]
Institut Curie [Paris]
Laé, Marick [Auteur]
Institut Curie [Paris]
Chakiba, Camille [Auteur]
Institut Bergonié [Bordeaux]
Michot, Audrey [Auteur]
Institut Bergonié [Bordeaux]
Penel, Nicolas [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Honoré, Charles [Auteur]
Institut Gustave Roussy [IGR]
Owen, Clémentine [Auteur]
Institut Gustave Roussy [IGR]
Bertucci, François [Auteur]
Institut Paoli-Calmettes [IPC]
Salas, Sébastien [Auteur]
Hôpital de la Timone [CHU - APHM] [TIMONE]
Saada-Bouzid, Esma [Auteur]
Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] [UNICANCER/CAL]
Valentin, Thibaud [Auteur]
Service Hématologie - IUCT-Oncopole [CHU Toulouse]
Bompas, Emmanuelle [Auteur]
Institut de Cancérologie de l'Ouest [Angers/Nantes] [UNICANCER/ICO]
Brahmi, Mehdi [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Ray-Coquard, Isabelle [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Blay, Jean-Yves [Auteur]
Université Claude Bernard Lyon 1 [UCBL]
Firmin, Nelly [Auteur]

Titre de la revue :

Annals of Surgical Oncology

Nom court de la revue :

Ann. Surg. Oncol.

Date de publication :

2020-02-01

ISSN :

1534-4681

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Background The optimal threshold of surgical margins for breast malignant phyllodes tumors (MPTs) and the impact of adjuvant chemotherapy and radiotherapy were investigated. Patients and Methods We conducted a ...
Lire la suite >Background The optimal threshold of surgical margins for breast malignant phyllodes tumors (MPTs) and the impact of adjuvant chemotherapy and radiotherapy were investigated. Patients and Methods We conducted a multicenter nationwide retrospective study of all MPT cases with central pathological review within the French Sarcoma Group. Endpoints were local recurrence-free survival (LRFS), metastasis-free survival (MFS), and overall survival (OS) rates. Results Overall, 212 patients were included in the study. All non-metastatic patients underwent primary surgical treatment, including 58.6% of conservative surgeries. An R0 resection was achieved in 117 patients (59.4%: 26.9% of patients with 1–2 mm margins, 12.2% of patients with 3–7 mm margins, 20.3% of patients with ≥ 8 mm margins). Ninety-four patients (45%) underwent a second surgery (SS) to obtain R0 margins, with a final mastectomy rate of 72.6%. Radiotherapy and chemotherapy were performed in 91 (43.1%) and 23 patients (10.9%), respectively, but were not associated with better outcomes. Mastectomy was significantly associated with better LRFS (p < 0.001). Margins of 0, 1, or 2 mm with SS were associated with better MFS (hazard ratio [HR] 0.3, p = 0.005) and OS (HR 0.32, p = 0.005) compared with margins of 0–1–2 mm without SS. Wider margins (> 8 mm) were not superior to margins of 3–7 mm (3–7 mm vs. > 8 mm; HR 0.81, p = 0.69). Age (HR 2.14, p = 0.038) and tumor necrosis (HR 1.96, p = 0.047) were found to be poor prognostic factors and were associated with MFS. Conclusions This study suggests that 3 mm margins are necessary and sufficient for surgical management of MPTs, and emphasizes the importance of SS to obtain clear margins in case of 0–1–2 mm margins. No impact of adjuvant chemotherapy or radiotherapy was detected in this study.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2023-11-15T09:29:31Z
2023-12-07T07:56:17Z