title: Retrospective analysis of 25 women with malignant cystosarcoma phyllodes--treatment results.
abstract: OBJECTIVE
  Mastectomy without axillary dissection should be the standard treatment in patients with malignant form of cystosarcoma phyllodes. The role of postoperative radiotherapy and chemotherapy remains to be fully established. We evaluate treatment results in a group of patients with cystosarcoma phyllodes (CP) treated at our Institute.
  
  
  METHODS
  In this report we analyze treatment outcome in 25 patients with malignant cystosarcoma phyllodes treated at Masaryk Memorial Cancer Institute between 1970 and 1995. Mean tumor size was 10 cm in diameter. All patients underwent surgery. Subsequently, 17 patients (68%) received radiotherapy on the breast or chest wall.
  
  
  RESULTS
  Median follow-up was 139.5 months. Local recurrence was observed in 16% of all patients and all patients with local recurrence died. Time to local relapse after surgery was 4-11 months. Distant metastases occurred in 5 patients. All patients with local recurrence had distant metastases. Dissemination occurred 3-19 months after local recurrence. Five-year survival of all patients was 80%.
  
  
  CONCLUSIONS
  A specific protocol for the treatment of cystosarcoma phyllodes is missing, probably due to rarity of the disease. The treatment of local recurrent disease remains unsuccessful in most CP patients. We recommend postoperative irradiation on the chest wall in patients with malignant form of CP, because adjuvant radiotherapy decreased the incidence of local relapse in our group of patients.
authors.affiliation: Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Zlutý kopec 7, 656 53 Brno, Czech Republic. soumarova@centrum.cz
authors.forename: Renata
authors.initials: R
authors.lastname: Soumarová
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Seneklová
authors.forename: Hana
authors.initials: H
authors.lastname: Horová
authors.forename: Hana
authors.initials: H
authors.lastname: Vojkovská
authors.forename: Ivana
authors.initials: I
authors.lastname: Horová
authors.forename: Marie
authors.initials: M
authors.lastname: Budíková
authors.forename: Jana
authors.initials: J
authors.lastname: Růzicková
authors.forename: Barbara
authors.initials: B
authors.lastname: Jezková
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D018153:Czech Republic / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D003557:Phyllodes Tumor / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D016019:Survival Analysis