Updates Surg. 2025 Apr 7. doi: 10.1007/s13304-025-02191-4. Online ahead of print.
ABSTRACT
We aimed to analyze the effect of surgical approach on patients with malignant phyllode tumor of the breast (MPTB) and to develop a prognostic prediction model for patients with MPTB. We extracted MPTB patients aged 18-80 years between 2000 and 2020 from the SEER database. Covariable imbalance was reduced using the propensity-score matching (PSM) method. An analysis of Cox proportional hazard regression was performed to compare breast cancer-specific survival (BCSS) with overall survival (OS). The survival curves were generated using the Kaplan-Meier method. The 5-year BCSS and 5-year OS of patients with MPTB were predicted by ten models based on machine learning. According to multivariate Cox analysis, surgical treatment of MPTB does not affect long-term survival outcomes (p > 0.05). Among our study, the survival outcomes of mastectomy and BCS would not be statistically significant even for patients with poor pathologic type of MPTB (p > 0.05). In terms of AUC, CatBoost performed better than other algorithms with a 5-year BCSS of 0.8488 and a 5-year OS of 0.8512. BCS and mastectomy do not make a significant difference in the long-term survival outcomes of patients with MPTB. Therefore, we suggest that BCS is feasible and preferred provided that surgical margin requirements can be met. As a trusted model, CatBoost provides better guidance and support for the systemic treatment of patients with MPTB.
PMID:40193050 | DOI:10.1007/s13304-025-02191-4
