目的:叶状肿瘤是罕见的乳腺肿瘤,指导治疗的前瞻性数据有限,导致这种疾病的异质性管理。我们使用改良的Delphi方法开发了全国共识声明,包括加拿大的患者和从业人员。
方法:声明是在文献综述的基础上制定的。通过计划的虚拟共识会议分发了两次调查。小组成员被邀请参加手术,放射肿瘤学,医学肿瘤学,病理学,放射学,整形手术。
结果:23名与会者参加了虚拟会议。关于诊断的一百份陈述,病理学,手术计划,辅助治疗,复发,监视,患者支持获得批准,先验定义的共识≥80%.制定并批准了两个关于区域管理的表格。交界叶状肿瘤的治疗是一个不确定性的来源,和建议反映了这种罕见的陈述缺乏证据。
结论:制定了一份包含所有已批准的叶状肿瘤治疗和治疗声明的共识文件,以帮助指导实践和未来的研究。
OBJECTIVE: Phyllodes tumors are rare breast neoplasms with limited prospective data to guide treatment, leading to heterogeneous management of this disease. We developed National
consensus statements using modified Delphi methodology including patients and practitioners across Canada.
METHODS: Statements were developed based on a literature review. Two iterations of surveys were distributed with a planned virtual
consensus meeting. Panelists were invited from surgery, radiation oncology, medical oncology, pathology, radiology, and plastic surgery.
RESULTS: Twenty-three participants attended the virtual conference. One hundred statements regarding diagnostics, pathology, surgical planning, adjuvant therapies, recurrence, surveillance, and patient support were approved with an a priori defined
consensus of ≥ 80%. Two tables on locoregional management were developed and approved. The management of borderline phyllodes tumors was a source of uncertainty, and recommendations reflect the lack of evidence in this rare presentation.
CONCLUSIONS: A
consensus document containing all approved statements for the care and management of phyllodes tumors was developed to help guide practice and future research.