Background/Objectives:Phyllodes tumors (PTs) are rare fibroepithelial breast neoplasms with a high propensity for local recurrence, particularly in borderline and malignant forms. Although wide local excision with negative margins is standard, the role of full-thickness chest wall resection (FTCWR) for PTs invading the chest wall remains unclear. This systematic review evaluated the outcomes of FTCWR in such cases, focusing on oncologic effectiveness and reconstruction.Methods:A comprehensive literature search of PubMed, Embase, Scopus databases, and Google Scholar (up to the end of November 2024) identified 18 case reports describing 18 patients (mean age of 42.9 years) with locally invasive PTs.Results:Most patients presented with large (>5 cm), recurrent malignant tumors fixed to the chest wall, with the largest measuring 38 cm. Median disease-free survival was 12 months (range: 1–60), with local recurrence in 5.6% and distant metastases in 22.2% of cases. Common complications included respiratory and wound-related issues. Despite the radical surgery, all patients achieved satisfactory cosmetic results.Conclusions:While FTCWR appears feasible and provides symptom relief and short-term disease control in select patients, the evidence remains limited to case reports. Its long-term oncologic benefit is still uncertain, and further research, including prospective studies and multi-center registries, is needed to elucidate its role in clinical practice.
背景/目的：叶状肿瘤是一种罕见的乳腺纤维上皮性肿瘤，具有较高的局部复发倾向，尤其在交界性和恶性类型中。尽管广泛局部切除并确保切缘阴性是标准治疗方式，但对于侵犯胸壁的叶状肿瘤，全层胸壁切除术的作用仍不明确。本系统综述评估了此类病例中全层胸壁切除术的疗效，重点关注肿瘤学效果与重建结果。 方法：通过对PubMed、Embase、Scopus数据库及Google Scholar（截至2024年11月底）进行全面文献检索，共纳入18篇病例报告，涉及18例局部侵袭性叶状肿瘤患者（平均年龄42.9岁）。 结果：多数患者表现为体积较大（>5厘米）、固定于胸壁的复发性恶性肿瘤，最大肿瘤直径达38厘米。中位无病生存期为12个月（范围：1-60个月），局部复发率为5.6%，远处转移率为22.2%。常见并发症包括呼吸系统问题及伤口相关并发症。尽管手术范围广泛，所有患者均获得了满意的美容效果。 结论：虽然全层胸壁切除术在特定患者中具有可行性，并能缓解症状、实现短期疾病控制，但现有证据仅限于病例报告。其长期肿瘤学获益仍不明确，需要进一步开展前瞻性研究和多中心注册研究，以明确该术式在临床实践中的作用。
肿瘤(癌症)患者之家