TITLE:
Management of Phylloid Sarcomas: A Retrospective Study of 12 Cases
AUTHORS:
Kanta Ka, Abdoul Halim Bague, Ibrahim Mounkeila, Mamadou Lassana Foba, N. Zongo, Davide Soldato, Filippo Dall’Olio, Mamadou Moustapha Dieng, Papa Macoumba Gaye, Daniele Presti
KEYWORDS:
Phylloid Sarcoma, Radiotherapy, Survival
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.10 No.2,
April
15,
2021
ABSTRACT: Background: Phylloid sarcomas are rare. There is not enough data to codify the
management. Objectives: The objective was to study the clinical and
therapeutic aspects and the fate of patients after a follow-up of at least 4
years. Thus contributing to the limited body of knowledge on these tumors. Methods: a retrospective analysis of the files from 2013 to 2017 was carried out and
patients were followed up until 2021at Hassan II Hospital. Epidemiological,
clinical and therapeutic aspects were studied. Survival was calculated using
the Kaplan-Meier method. Results: We collected 12 charts of patients
treated for phyllodeal sarcoma from 2013 to 2017. The median age was 43 years.
The circumstance of discovery was marked by the presence of nodule in all
patients. The coupled echo-mammography examination classified the nodules, ACR
4 in 7 patients and ACR 3 in 3 and ACR 5 in 2 patients. Histological
examination revealed a phylloid sarcoma in 11 patients and a borderline
phylloid tumor in 1 patient. All patients had radical surgery with positive
margins in 2 patients, 16.66%. One patient had revision surgery. Histological
examination of the surgical specimens showed phylloid sarcoma on all specimens.
All patients had adjuvant radiotherapy with doses of 50 Gy in 25 fractions of 2
Gy and a boost of 10 Gy was done in one patient. The median spread of
radiotherapy was 37 days. Grade 1 and 2 skin toxicities were noted in 5 and 3
patients respectively. The median time from surgery to radiotherapy was 2.95
months. 3 patients relapsed after 13.6 months of follow-up. The recurrence-free
survival at 1 and 3 years was 83% and 75% respectively. Overall survival at 3
and 5 years was 83% and 75% respectively. Conclusion: This is a rare
entity which requires randomized trials to codify its management. It would seem that the multidisciplinary
approach, associating surgery ± radiotherapy, is a good option.