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Table 1 A summary of studies with metastatic PT

From: Distant metastases in phyllodes tumours of the breast: an overview

Authors, year of publication

No. of cases

Total metastatic rate, % (no. of cases)

Metastatic rate by tumour grade, % (no. of cases)

Site(s) of metastasis

PT-related death rate, % (no. of cases)

Metastatic death rate, % (no. of cases)

Time to metastasis from diagnosis (months)

Time to death (months)

Factors associated with metastasis

Axillary lymph node metastasis, % (no. of cases)

Benign

Borderline

Malignant

Lindquist et al. 1982 [16]

42

9.5 (4/42)

0/3a

0

4/7

Chest wall, liver, lungs, retroperitoneum

50.0 (5/10)

100 (4/4)

Range 0 - 84

PT diagnosis to death: Range 21-84

NAb

NA

Ward and Evans 1986c [19]

26

19.2 (5/26)

-

-

-

Gastrointestinal tract, lung, spleen, thyroid, uterus

26.9 (7/26)

100 (5/5)

NA

PT diagnosis to death: range 6 - 32

Stromal overgrowth

0

Hawkins et al. 1992c [26]

33

24.2 (8/33)

-

-

-

Bone, lung, mesentery, muscle or soft tissue, pleura, skin

21.2 (7/33)

87.5 (7/8)

Median 14 (range 2 - 31)

DMd to death: Median 10 (range 2 - 40) PT diagnosis to death: Median 25 (range 12 - 50)

Severe nuclear pleomorphism, stromal overgrowth, high mitotic count, infiltrating margins, large tumour size, presence of necrosis

NA

Rowell et al. 1993 [30]

18

5.6 (1/18)

0 (0/11)

0 (0/4)

33.3 (1/3)

Lung, muscles

5.6 (1/18)

100 (1/1)

NA

PT diagnosis to death: 23

NA

0

Reinfuss et al. 1996 [7]

170

15.9 (27/170)

3.3 (3/92)

21.1 (4/19)

33.9 (20/59)

Bone, brain, lung

15.9 (27/170)

100 (27/27)

Mean 18 (range 2 - 57)

Mean 4 (range 2 - 11)

NA

0.5 (1/70)

de Roos et al. 1999 [39]

38

10.5 (4/38)

0 (0/15)

0 (0/11)

33.3 (4/12)

NA

10.5 (4/38)

100 (4/4)

NA

Median 17 (range 12 - 125)

Size and grade related to metastatic death

NA

Mangi et al. 1999 [8]

40

2.5 (1/40)

2.9 (1/34)

0 (0/3)

0 (0/3)

NA

2.5 (1/40)

100 (1/1)

36

NA

None

NA

Chaney et al. 2000 [9]

101

7.9 (8/101)

1.7 (1/59)

0 (0/12)

23.3 (7/30)

Brain, lung, pelvis

NA

100 (8/8)

NA

NA

Stromal overgrowth, malignant histology, mastectomy

0

Kapiris et al. 2001e [6]

48

27.1 (13/48)

-

-

27.1 (13/48)

Bone, lung, pleura

35.4 (17/48)

92.3 (12/13)

Median 25.6 (range 6 - 120)

DM to death: mean 16.6 (range 1 - 24)

Tumour size, margins

0

Asoglu et al. 2004 [10]

50

26.0 (13/50)

6.3 (1/16)

33.3 (1/3)

35.5 (11/31)

Abdomen, bone, brain, liver, lung

32.0 (16/50)

100 (13/13)

Mean 53.4, median 36 (range 4 - 77)

DM to death: mean 7 (range 1 - 19)

Stromal overgrowth

2 (1/50)

Chen et al. 2005 [5]

172

1.7 (3/172)

0 (0/131)

8.3 (1/12)

6.9 (2/29)

Lung, soft tissue of neck

NA

100 (3/3)

NA

DM to death: 5 (patient 1), 6 (patient 2). No info on 3rd patient

Stromal cellularity, stromal overgrowth, stromal atypia, mitotic activity, tumour margin, heterologous stromal elements

0

Sotheran et al. 2005 [27]

50

2.0 (1/50)

0 (0/29)

0 (0/12)

11.1 (1/9)

Musculoskeletal chest wall

2.0 (1/50)

100 (1/1)

18

NA

NA

NA

Abdalla et al. 2006 [11]

79

12.7 (10/79)

3.2 (1/31)

11.1 (3/27)

28.6 (6/21)

Bone, brain, lung

12.7 (10/79)

100 (10/10)

Median 14 (range 3 - 36)

DM to death: Mean 5 (range 1 - 11)

Histotypes and resection margins

1.3 (1/79)

Tan et al. 2006 [48]

37

16.2 (6/37)

0 (0/22)

0 (0/9)

100 (6/6)

Bone, lungs, pleura

8.1 (3/37)

50 (3/6)

NA

Mean 11.3

NA

NA

Cheng et al. 2006 [12]

182

2.2 (4/182)

0 (0/138)

7.7 (1/13)

9.7 (3/31)

Lungs

2.2 (4/182)

100 (4/4)

Mean 14

Mean 6 (range 5 - 9)

None

0

Belkacémi et al. 2008 [13]

443

3.4 (15/443)

0 (0/284)

2.5 (2/80)

16.5 (13/79)

Lung

NA

NA

NA

NA

NA

0.2 (1/443)

Lenhard et al. 2008 [24]

33

9.1 (3/33)

0 (0/13)

0 (0/9)

27.3 (3/11)

Liver, lung

3.1 (1/32) (1 lost follow-up)

50 (1/2) (1 lost follow-up)

Median 40 (range 4 - 56)

26 (DM at diagnosis)

Histopathological classification

0

Guillot et al. 2011 [49]

165

1.2 (2/165)

0 (0/114)

0 (0/37)

14.3 (2/14)

Bone, lung

1.2 (2/165)

100 (2/2)

NA

NA

NA

0

Al-Masri et al. 2012 [40]

43

14.0 (6/43)

0 (0/16)

0 (0/10)

35.3 (6/17)

NA

NA

NA

NA

NA

Expression of stromal CD10

NA

Jang et al. 2012 [50]

164

2.4 (4/164)

0 (0/82)

0 (0/42)

10.0 (4/40)

Bone, lung

1.8 (3/164)

75 (3/4)

NA

NA

NA

NA

Tan et al. 2012 [2]

605

2.0 (12/605)

0 (0/440)

0 (0/111)

22.2 (12/54)

Liver, lung, pleura, soft tissue, vertebra

2.0 (12/605)

NA

NA

NA

NA

NA

Do et al. 2013 [51]

179

2.8 (5/179)

0 (0/103)

0 (0/38)

13.2 (5/38)

NA

2.2 (4/179)

60 (3/5)

NA

NA

None

NA

Sawalhi and Shatti 2013 [20]

42

14.3 (6/42)

0 (0/16)

0 (0/9)

35.3 (6/17)

Bone, intestine, lung, thigh

NA

NA

Mean 15.9

NA

Histological grade

14.3 (6/42)

Spitaleri et al. 2013 [3]

172

2.3 (4/172)

0 (0/68)

0 (0/42)

6.5 (4/62)

NA

2.3 (4/172)

75.0 (3/4)

NA

NA

Young age (<35 years), presence of necrosis, positive surgical margins associated with increased risk of all PT-related events

NA

Ren et al. 2014 [14]

140

7.1 (10/140)

0 (0/80)

6.7 (2/30)

26.7 (8/30)

NA

NA

NA

NA

NA

Tumour grade, expression of Axl and ST6GaINAcII

NA

Wei et al. 2014 [15]

192

6.3 (12/192)

0 (0/80)

6.3 (4/63)

16.3 (8/49)

Bone, liver, lung, pancreas, pleura, soft tissue, thoracic cavity

6.3 (12/192)

100 (12/12)

Median 26 (range 0 - 60)

DM to death: Median 10.0 (range 2.0 - 41.1) PT diagnosis to death: Median 34.3 (range 14.0 - 80.0)

Histotype, margin status

0

Bumpers et al. 2015 [52]

50

2.0 (1/50)

0 (0/40)

0 (0/3)

14.3 (1/7)

Lung

2.0 (1/50)

100 (1/1)

Lung metastasis found at time of presentation

PT diagnosis to death: 4

NA

4 (2/50)

Ramakant et al. 2015 [17]

167

4.2 (7/167)

0 (0/118)f

14.3 (7/49)

Adrenal, bone, brain, duodenum, lung, mediastinal nodes, para-aortic nodes

NA

85.7 (6/7)

Median 7 (range 0 - 156)

NAg

NA

1.2 (2/167) (para-aortic and mediastinal nodes)

Demian et al. 2016 [53]

35

2.9 (1/35)

0 (0/1)

0 (0/13)

4.8 (1/21)

Lung

Lost follow-up

Lost follow-up

NA

NA

-

0

Total

3516

5.6 (196/3516)

0.4 (7/1915)

2.9 (18/612)

20.0 (154/770)

 
  1. aAlthough the total number of patients with PT was 46, the study only looked at 10 patients with recurrence and/or distant metastasis, as such, the percentages of benign, borderline, and malignant PT were not tabulated and included in the total metastatic rates of benign, borderline, and malignant PTs
  2. b NA Information was not available
  3. cCases were not specified to be benign, borderline, or malignant
  4. d DM Distant metastasis
  5. eThis study looked only at high-grade malignant PTs
  6. fAs the exact breakdown of benign and borderline cases were not known, these numbers were not computed in the total metastatic rates of benign and borderline PTs
  7. gThe follow-up of each patient was detailed in the study, however the starting time points to death (i.e from diagnosis of PTs, or distant metastases or surgery etc.) were not consistent for all patients, therefore we were not able to tabulate a mean, median or range of time to death