Full-Thickness Chest Wall Resection and Reconstruction for Locally Invasive Phyllodes Tumors: A Systematic Review.

Area of Science:

• Surgical Oncology
• Breast Neoplasms
• Thoracic Surgery

Background:

• Phyllodes tumors (PTs) are rare fibroepithelial breast neoplasms.
• Borderline and malignant PTs have a high risk of local recurrence.
• The role of full-thickness chest wall resection (FTCWR) for PTs invading the chest wall is not well-defined.

Purpose of the Study:

• To systematically review the outcomes of FTCWR in patients with locally invasive PTs.
• To evaluate the oncologic effectiveness and reconstruction following FTCWR for PTs.
• To assess complications and cosmetic results associated with FTCWR for PTs.

Main Methods:

• Comprehensive literature search of PubMed, Embase, Scopus, and Google Scholar.
• Inclusion of 18 case reports describing 18 patients with locally invasive PTs.
• Analysis of patient demographics, tumor characteristics, surgical outcomes, and follow-up data.

Main Results:

• Most patients had large (>5 cm), recurrent malignant PTs fixed to the chest wall.
• Median disease-free survival was 12 months; local recurrence occurred in 5.6%, distant metastases in 22.2%.
• Common complications included respiratory and wound issues; all patients had satisfactory cosmetic results.

Conclusions:

• FTCWR appears feasible for select patients with locally invasive PTs, providing symptom relief and short-term disease control.
• Evidence is limited to case reports, and long-term oncologic benefit remains uncertain.
• Further research, including prospective studies, is needed to clarify the role of FTCWR in PT management.