From the Research
The 5-year overall survival rate for malignant phyllodes tumors is approximately 52% according to the most recent and highest quality study. When considering the management of malignant phyllodes tumors, several factors influence the outcome, including tumor size, surgical margins, histological grade, and metastatic status.
- Larger tumors (>5cm) and higher histological grade are associated with worse outcomes, as seen in studies such as 1 and 2.
- Complete surgical excision with wide negative margins (at least 1cm) is the primary treatment that improves survival, as supported by 3 and 4.
- Local recurrence occurs in approximately 20-30% of malignant cases, typically within the first few years after treatment, highlighting the importance of regular follow-up, as noted in 3 and 4.
- Unlike many breast cancers, malignant phyllodes tumors typically spread hematogenously to lungs and bones rather than lymphatically, which influences their treatment approach and survival patterns, as discussed in 5.
- Adjuvant radiation therapy may be considered in certain cases, such as when tumor-free margins are <1cm, as suggested by 3 and 2.
- The use of chemotherapy, such as the combination of cisplatin with nab-paclitaxel and liposomal doxorubicin, may be effective in eradicating metastatic lesions, as demonstrated in 5. Overall, the management of malignant phyllodes tumors requires a multidisciplinary approach, taking into account the individual patient's tumor characteristics and treatment goals.