Risk Factors Affecting the Recurrence of Phyllodes Tumor at Dr. Soetomo General Hospital in 2019–2024

Abstract

This study aimed to identify the risk factors influencing recurrence among patients treated surgically at Dr. Soetomo General Hospital from 2019 to 2024. This was a descriptive observational study with a cross-sectional design. Medical records of patients diagnosed with phyllodes tumors and surgically treated at Dr. Soetomo General Hospital between 2019 and 2024 were reviewed. A total of 70 patients who met the inclusion criteria were included. Variables analyzed included age, family history, tumor grade, tumor size, type of surgery, adjuvant radiotherapy, surgical margin status, stromal cellularity, stromal atypia, mitotic rate, and Ki-67 index. Most patients were younger than 65 years (65.7%), presented with benign– borderline tumors, had tumors smaller than 5 cm (68.6%), and underwent wide excision without radiotherapy (92.9%). Recurrence occurred in 10 patients (14.3%), with an average disease-free interval of 23 months. The most significant risk factor for recurrence was inadequate surgical margins (<1–2 cm). Other contributing factors included age, type of surgery, high mitotic activity, and excessive stromal overgrowth. The recurrence rate of phyllodes tumors at Dr. Soetomo General Hospital was relatively low. However, inadequate or positive surgical margins remain the primary risk factor for recurrence. Appropriate surgical techniques ensuring adequate margins and a follow-up period of at least 2–3 years are crucial for early detection and management of recurrence.