{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:13:43Z","timestamp":1789730023675,"version":"4.0.1"},"reference-count":27,"publisher":"Harborside Press, LLC","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Malignant phyllodes tumors (MPTs) are rare breast tumors with high risks of local recurrence and distant metastasis. Surgical intervention is the primary treatment, but the effectiveness of adjuvant therapies is uncertain. This study was designed to analyze the prognostic risk factors associated with MPTs and evaluate the efficacy of postoperative adjuvant chemotherapy.\n                    <jats:bold>Patients and Methods:<\/jats:bold>\n                    Patients who were first diagnosed with MPT without distant metastasis and received R0 resection surgery between 1999 and 2023 were included in the present study and stratified into 2 groups: chemotherapy and nonchemotherapy groups. Propensity score matching (PSM) was used to balance baseline characteristics between groups. Kaplan-Meier curves were used to estimate local recurrence\u2013free survival (LRFS) and overall survival (OS). Cox proportional hazards analyses (univariate and multivariate) were conducted to identify prognostic risk factors.\n                    <jats:bold>Results:<\/jats:bold>\n                    We conducted a study involving 145 patients, 31 of whom underwent a total of 12 different chemotherapy regimens following initial surgical resection. Most patients received chemotherapy regimens primarily consisting of anthracyclines, including anthracycline + ifosfamide (AI) or anthracycline + cyclophosphamide\/docetaxel (AC-T) regimens. After a median follow-up of 54.5 months, 37 (25.5%) patients experienced local recurrence and 24 (16.6%) experienced distant metastasis. No significant difference was detected in the rates of local recurrence or distant metastasis between the 2 groups. Axillary lymph node positivity was the only risk factor for LRFS, whereas older age, larger tumors, axillary lymph node positivity, local recurrence, and distant metastasis were significantly associated with worse OS. Chemotherapy did not emerge as a protective factor for LRFS (\n                    <jats:italic>P<\/jats:italic>\n                    =.501) or OS (\n                    <jats:italic>P<\/jats:italic>\n                    =.854). After PSM, patients in the chemotherapy group did not exhibit better 5-year LRFS (\n                    <jats:italic>P<\/jats:italic>\n                    =.934) or 5-year OS (\n                    <jats:italic>P<\/jats:italic>\n                    =.328).\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    According to our retrospective evaluation, postoperative adjuvant chemotherapy was not associated with improved survival in patients with MPTs without distant metastasis.\n                  <\/jats:p>","DOI":"10.6004\/jnccn.2024.7023","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T13:56:27Z","timestamp":1722261387000},"source":"Crossref","is-referenced-by-count":15,"title":["The Impact of Adjuvant Chemotherapy on the Long-Term Prognosis of Breast Malignant Phyllodes Tumors: A Propensity Score\u2013Matched Study"],"prefix":"10.6004","volume":"22","author":[{"given":"Zilin","family":"Zhuang","sequence":"first","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailifeire","family":"Yilihamu","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery, Third Hospital of Nanchang, Nanchang, JiangXi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Lei","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xun","family":"Li","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjia","family":"Han","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangxin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Ma","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Xi\u2019an Jiaotong University, Shan Xi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery, Third Hospital of Nanchang, Nanchang, JiangXi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Breast and Thyroid Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyun","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Nie","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Medical Research Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"},{"name":"Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"Technol Cancer Res Treat","article-title":"Long-term survival after diverse therapeutic modalities in malignant phyllodes tumors of the breast","volume":"21","author":"Zhang H","year":"2022","unstructured":"Zhang H, Tang S, Biskup E,  Long-term survival after diverse therapeutic modalities in malignant phyllodes tumors of the breast. Technol Cancer Res Treat 2022;21:15330338221121086."},{"key":"B2","author":"Gradishar WJ","year":"2023","unstructured":"Gradishar WJ, Moran MS, Abraham J  NCCN Clinical Practice Guidelines in Oncology: Breast Cancer. Version 4.2023. Accessed March 23, 2023. To view the most recent version, visit https:\/\/www.nccn.org"},{"key":"B3","series-title":"Ann Surg Oncol","first-page":"2288","article-title":"A prospective, multi-institutional study of adjuvant radiotherapy after resection of malignant phyllodes tumors","volume":"16","author":"Barth RJ Jr","year":"2009","unstructured":"Barth RJ Jr, Wells WA, Mitchell SE,  A prospective, multi-institutional study of adjuvant radiotherapy after resection of malignant phyllodes tumors. Ann Surg Oncol 2009;16:2288\u20132294."},{"key":"B4","series-title":"Breast J","first-page":"551","article-title":"Adjuvant chemotherapy with doxorubicin and dacarbazine has no effect in recurrence-free survival of malignant phyllodes tumors of the breast","volume":"13","author":"Morales-V\u00e1squez F","year":"2007","unstructured":"Morales-V\u00e1squez F, Gonzalez-Angulo AM, Broglio K,  Adjuvant chemotherapy with doxorubicin and dacarbazine has no effect in recurrence-free survival of malignant phyllodes tumors of the breast. Breast J 2007;13:551\u2013556."},{"key":"B5","series-title":"Int J Radiat Oncol Biol Phys","first-page":"492","article-title":"Phyllodes tumor of the breast","volume":"70","author":"Belkac\u00e9mi Y","year":"2008","unstructured":"Belkac\u00e9mi Y, Bousquet G, Marsiglia H,  Phyllodes tumor of the breast. Int J Radiat Oncol Biol Phys 2008;70:492\u2013500."},{"key":"B6","series-title":"Ann Surg Oncol","first-page":"1011","article-title":"Risk factors for recurrence and death after primary surgical treatment of malignant phyllodes tumors","volume":"11","author":"Asoglu O","year":"2004","unstructured":"Asoglu O, Ugurlu MM, Blanchard K,  Risk factors for recurrence and death after primary surgical treatment of malignant phyllodes tumors. Ann Surg Oncol 2004;11:1011\u20131017."},{"key":"B7","series-title":"Histopathology","first-page":"5","article-title":"Phyllodes tumours of the breast: a consensus review","volume":"68","author":"Tan BY","year":"2016","unstructured":"Tan BY, Acs G, Apple SK,  Phyllodes tumours of the breast: a consensus review. Histopathology 2016;68:5\u201321."},{"key":"B8","series-title":"Ann Surg Oncol","first-page":"3304","article-title":"Surgical treatment of borderline and malignant phyllodes tumors: the effect of the extent of resection and tumor characteristics on patient outcome","volume":"21","author":"Onkendi EO","year":"2014","unstructured":"Onkendi EO, Jimenez RE, Spears GM,  Surgical treatment of borderline and malignant phyllodes tumors: the effect of the extent of resection and tumor characteristics on patient outcome. Ann Surg Oncol 2014;21:3304\u20133309."},{"key":"B9","series-title":"Br J Surg","first-page":"396","article-title":"Factors leading to local recurrence or death after surgical resection of phyllodes tumours of the breast","volume":"86","author":"de Roos WK","year":"1999","unstructured":"de Roos WK, Kaye P, Dent DM. Factors leading to local recurrence or death after surgical resection of phyllodes tumours of the breast. Br J Surg 1999;86:396\u2013399."},{"key":"B10","series-title":"Eur J Surg Oncol","first-page":"723","article-title":"Outcome and predictive factors of local recurrence and distant metastases following primary surgical treatment of high-grade malignant phyllodes tumours of the breast","volume":"27","author":"Kapiris I","year":"2001","unstructured":"Kapiris I, Nasiri N, A\u2019Hern R,  Outcome and predictive factors of local recurrence and distant metastases following primary surgical treatment of high-grade malignant phyllodes tumours of the breast. Eur J Surg Oncol 2001;27:723\u2013730."},{"key":"B11","series-title":"J Egypt Natl Canc Inst","first-page":"125","article-title":"Predictive factors of local recurrence and survival following primary surgical treatment of phyllodes tumors of the breast","volume":"18","author":"Abdalla HM","year":"2006","unstructured":"Abdalla HM, Sakr MA. Predictive factors of local recurrence and survival following primary surgical treatment of phyllodes tumors of the breast. J Egypt Natl Canc Inst 2006;18:125\u2013133."},{"key":"B12","series-title":"Cancer","first-page":"910","article-title":"The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases","volume":"77","author":"Reinfuss M","year":"1996","unstructured":"Reinfuss M, Mitu\u015b J, Duda K,  The treatment and prognosis of patients with phyllodes tumor of the breast: an analysis of 170 cases. Cancer 1996;77:910\u2013916."},{"key":"B13","series-title":"BMC Med Res Methodol","first-page":"132","article-title":"A review of the use of propensity score diagnostics in papers published in high-ranking medical journals","volume":"20","author":"Granger E","year":"2020","unstructured":"Granger E, Watkins T, Sergeant JC,  A review of the use of propensity score diagnostics in papers published in high-ranking medical journals. BMC Med Res Methodol 2020;20:132."},{"key":"B14","series-title":"Ann Surg Oncol","first-page":"1222","article-title":"Utilization of radiotherapy for malignant phyllodes tumors: analysis of the National Cancer Data Base, 1998\u20132009","volume":"21","author":"Gnerlich JL","year":"2014","unstructured":"Gnerlich JL, Williams RT, Yao K,  Utilization of radiotherapy for malignant phyllodes tumors: analysis of the National Cancer Data Base, 1998\u20132009. Ann Surg Oncol 2014;21:1222\u20131230."},{"key":"B15","series-title":"BMC Cancer","first-page":"372","article-title":"Adjuvant radiotherapy and chemotherapy for patients with breast phyllodes tumors: a systematic review and meta-analysis","volume":"19","author":"Chao X","year":"2019","unstructured":"Chao X, Chen K, Zeng J,  Adjuvant radiotherapy and chemotherapy for patients with breast phyllodes tumors: a systematic review and meta-analysis. BMC Cancer 2019;19:372."},{"key":"B16","series-title":"Breast","first-page":"1","article-title":"Phyllodes tumors of the breast: adjuvant radiation therapy revisited","volume":"58","author":"Boutrus RR","year":"2021","unstructured":"Boutrus RR, Khair S, Abdelazim Y,  Phyllodes tumors of the breast: adjuvant radiation therapy revisited. Breast 2021;58:1\u20135."},{"key":"B17","series-title":"Breast Care (Basel)","first-page":"194","article-title":"Effectiveness of MAID therapy against metastatic malignant phyllodes tumors and stromal sarcoma of the breast","volume":"1","author":"Yonemori K","year":"2006","unstructured":"Yonemori K, Shimizu C, Hasegawa T,  Effectiveness of MAID therapy against metastatic malignant phyllodes tumors and stromal sarcoma of the breast. Breast Care (Basel) 2006;1:194\u2013197."},{"key":"B18","series-title":"Breast J","first-page":"639","article-title":"Malignant phyllodes tumor of the breast: treatment and prognosis","volume":"20","author":"Mitu\u015b J","year":"2014","unstructured":"Mitu\u015b J, Reinfuss M, Jakubowicz J,  Malignant phyllodes tumor of the breast: treatment and prognosis. Breast J 2014;20:639\u2013644."},{"key":"B19","series-title":"Breast Cancer Res Treat","first-page":"603","article-title":"Systemic treatment in advanced phyllodes tumor of the breast: a multi-institutional European retrospective case-series analyses","volume":"192","author":"Palassini E","year":"2022","unstructured":"Palassini E, Mir O, Grignani G,  Systemic treatment in advanced phyllodes tumor of the breast: a multi-institutional European retrospective case-series analyses. Breast Cancer Res Treat 2022;192:603\u2013610."},{"key":"B20","series-title":"Breast Cancer Res Treat","first-page":"871","article-title":"Outcomes of systemic therapy in metastatic phyllodes tumor of the breast","volume":"186","author":"Parkes A","year":"2021","unstructured":"Parkes A, Wang WL, Patel S,  Outcomes of systemic therapy in metastatic phyllodes tumor of the breast. Breast Cancer Res Treat 2021;186:871\u2013882."},{"key":"B21","series-title":"Ann Surg Oncol","first-page":"1693","article-title":"Impact of metastasis surgery and alkylating-agent-based chemotherapy on outcomes of metastatic malignant phyllodes tumors: a multicenter retrospective study","volume":"27","author":"Neron M","year":"2020","unstructured":"Neron M, Sajous C, Thezenas S,  Impact of metastasis surgery and alkylating-agent-based chemotherapy on outcomes of metastatic malignant phyllodes tumors: a multicenter retrospective study. Ann Surg Oncol 2020;27:1693\u20131699."},{"key":"B22","series-title":"Breast Cancer Res Treat","first-page":"353","article-title":"Analysis of phyllodes tumor recurrence according to the histologic grade","volume":"141","author":"Kim S","year":"2013","unstructured":"Kim S, Kim JY, Kim DH,  Analysis of phyllodes tumor recurrence according to the histologic grade. Breast Cancer Res Treat 2013;141:353\u2013363."},{"key":"B23","series-title":"Cancer Manag Res","first-page":"7805","article-title":"Phyllodes tumor of the breast: diagnosis, management and outcome during a 10-year experience","volume":"11","author":"Ditsatham C","year":"2019","unstructured":"Ditsatham C, Chongruksut W. Phyllodes tumor of the breast: diagnosis, management and outcome during a 10-year experience. Cancer Manag Res 2019;11:7805\u20137811."},{"key":"B24","series-title":"Am J Surg","first-page":"141","article-title":"Phyllodes tumors of the breast: a case series of 106 patients","volume":"192","author":"Ben Hassouna J","year":"2006","unstructured":"Ben Hassouna J, Damak T, Gamoudi A,  Phyllodes tumors of the breast: a case series of 106 patients. Am J Surg 2006;192:141\u2013147."},{"key":"B25","series-title":"Chin J Cancer","first-page":"492","article-title":"Predictive factors for the local recurrence and distant metastasis of phyllodes tumors of the breast: a retrospective analysis of 192 cases at a single center","volume":"33","author":"Wei J","year":"2014","unstructured":"Wei J, Tan YT, Cai YC,  Predictive factors for the local recurrence and distant metastasis of phyllodes tumors of the breast: a retrospective analysis of 192 cases at a single center. Chin J Cancer 2014;33:492\u2013500."},{"key":"B26","series-title":"Cancer","first-page":"1502","article-title":"Primary treatment of cystosarcoma phyllodes of the breast","volume":"89","author":"Chaney AW","year":"2000","unstructured":"Chaney AW, Pollack A, McNeese MD,  Primary treatment of cystosarcoma phyllodes of the breast. Cancer 2000;89:1502\u20131511."},{"key":"B27","series-title":"J Surg Oncol","first-page":"185","article-title":"Surgical treatment of phyllodes tumors of the breast: retrospective review of 172 cases","volume":"91","author":"Chen WH","year":"2005","unstructured":"Chen WH, Cheng SP, Tzen CY,  Surgical treatment of phyllodes tumors of the breast: retrospective review of 172 cases. J Surg Oncol 2005;91:185\u2013194."}],"container-title":["Journal of the National Comprehensive Cancer Network"],"original-title":[],"link":[{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/22\/7\/article-e247023.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/22\/7\/article-e247023.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jnccn.org\/downloadpdf\/journals\/jnccn\/22\/7\/article-e247023.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T15:54:07Z","timestamp":1725551647000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnccn.org\/view\/journals\/jnccn\/22\/7\/article-e247023.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":27,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.6004\/jnccn.2024.7023","relation":{},"ISSN":["1540-1405","1540-1413"],"issn-type":[{"value":"1540-1405","type":"print"},{"value":"1540-1413","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}