Abstract
Background
Thoracic solitary fibrous tumors (TSFTs) are uncommon mesenchymal tumors. The data regarding surgical outcomes and prognostic factors are scarce. This retrospective paper is to analyze surgical outcomes, clinical characteristics and prognosis of TSFT.
Methods
A single-center retrospective study of the data of 70 patients with TSFT who underwent surgical resection in our department between August 2008 and October 2014 was conducted.
Results
A total of 70 TSFTs (58 benign, 12 malignant) were included and all patients underwent complete surgical resection except one recurrent patient with initial treatment. TSFTs originated from the pleura (n = 43), lung (n = 9), mediastinum (n = 16), esophagus (n = 1) and diaphragm (n = 1), respectively. Mass excision was only performed in 29 patients, en bloc excision including surrounding structures was performed in 41 patients. During follow-up, no tumor recurrence occurred in benign TSFT patients. All recurrences occurred in 6 malignant patients, and 5 of them died because of local recurrence and distant metastasis. Median follow-up was 95 months (range, 3–133 months). The 5-year overall survival (OS) of TSFT patients was 94.3%. The 5-year relapse-free survival and OS of malignant TSFT patients were 58.3% and 66.7%, respectively.
Conclusion
The gold standard of TSFT treatment is complete surgical resection. VATS is safe and reliable for treating selected TSFT patients. Aggressive surgical resection could be underwent in such patients of local recurrence or solitary metastatic tumor. A long-term follow-up is necessary due to the risk of recurrence.
Similar content being viewed by others
References
Bellini A, Marulli G, Breda C et al (2019) Predictors of behaviour in solitary fibrous tumours of the pleura surgically resected: analysis of 107 patients[J]. J Surg Oncol 120(4):761–767
Cardillo G, Facciolo F, Cavazzana AO et al (2000) Localized (solitary) fibrous tumours of the pleura: an analysis of 55 patients[J]. Ann Thorac Surg 70:1808–1812
Cardillo G, Carbone L, Carleo F et al (2009) Solitary fibrous tumors of the pleura: an analysis of 110 patients treated in a single institution[J]. Ann Thorac Surg 88(5):1632–1637
Cho EY, Han JJ, Han J et al (2007) Fine needle aspiration cytology of solitary fibrous tumours of the pleura[J]. Cytopathology 18(1):20–27
Demicco EG, Park MS, Araujo DM et al (2012) Solitary fibrous tumour: a clinicopathological study of 110 cases and proposed risk assessment model[J]. Mod Pathol 25(9):1298–1306
England DM, Hochholzer L, McCarthy MJ (1989) Localized benign and malignant fibrous tumours of the pleura. A clinicopathologic review of 223 cases[J]. Am J Surg Pathol 13(8):640–658
Filosso PL, Asioli S, Ruffini E et al (2009) Radical resection of a giant, invasive and symptomatic malignant solitary fibrous tumour (SFT) of the pleura[J]. Lung Cancer 64(1):117–120
Gold JS, Antonescu CR, Hajdu C et al (2002) Clinicopathologic correlates of solitary fibrous tumors[J]. Cancer 94(4):1057–1068
Gupta A, Souza CA, Sekhon HS et al (2017) Solitary fibrous tumour of pleura: CT differentiation of benign and malignant types[J]. Clin Radiol 72(9):796.e9–796.e17
Hanau CA, Miettinen M (1995) Solitary fibrous tumors: histological and immunohistochemical spectrum of benign and malignant variants presenting at different sites[J]. Hum Pathol 26(4):440–449
Harrison-Phipps KM, Nichols FC, Schleck CD et al (2009) Solitary fibrous tumors of the pleura: results of surgical treatment and long-term prognosis[J]. J Thorac Cardiovasc Surg 138(1):19–25
Kovacs T, Waxman J (2019) Recurrence of a malignant solitary fibrous tumor of the pleura 17 years after primary tumor resection—a case report[J]. Respir Med Case Rep 28:100895
Lahon B, Mercier O, Fadel E et al (2012) Solitary fibrous tumour of the pleura: outcomes of 157 complete resections in a single center[J]. Ann Thorac Surg 94(2):394–400
Liang Y, Heller RS, Wu JK et al (2019) High p16 expression is associated with malignancy and shorter disease-free survival time in solitary fibrous tumor/hemangiopericytoma[J]. J Neurol Surg B Skull Base 80(3):232–238
Liu CC, Wang HW, Li FY et al (2008) Solitary fibrous tumors of the pleura: clinicopathological characteristics, immunohistochemical profiles, and surgical outcomes with long-term follow-up[J]. Thorac Cardiovasc Surg 56(5):291–297
Lococo F, Cesario A, Cardillo G et al (2012) Malignant solitary fibrous tumors of the pleura: retrospective review of a multicenter series[J]. J Thorac Oncol 7(11):1698–1706
Magdeleinat P, Alifano M, Petino A et al (2002) Solitary fibrous tumors of the pleura: clinical characteristics, surgical treatment and outcome[J]. Eur J Cardiothorac Surg 21(6):1087–1093
Martin-Broto J, Stacchiotti S, Lopez-Pousa A et al (2019) Pazopanib for treatment of advanced malignant and dedifferentiated solitary fibrous tumour: a multi-centre, single-arm, phase 2 trial[J]. Lancet Oncol 20(1):134–144
Milano MT, Singh DP, Zhang H (2011) Thoracic malignant solitary fibrous tumors: a population-based study of survival[J]. J Thorac Dis 3(2):99–104
Nagahiro I, Andou A, Aoe M et al (2001) Pulmonary function, postoperative pain and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure[J]. Ann Thorac Surg 72(2):362–365
Okike N, Bernatz PE, Woolner LB (1978) Localized mesothelioma of the pleura: benign and malignant variants[J]. J Thorac Cardiovasc Surg 75(3):363–372
Rena O, Filosso PL, Papalia E et al (2001) Solitary fibrous tumour of the pleura: surgical treatment[J]. Eur J Cardiothorac Surg 19(2):185–189
Suehisa H, Yamashita M, Komori E et al (2010) Solitary fibrous tumor of the mediastinum[J]. Gen Thorac Cardiovasc Surg 58(4):205–208
Tapias LF, Mercier O, Ghigna MR et al (2015) Validation of a scoring system to predict recurrence of resected solitary fibrous tumors of the pleura[J]. Chest 147(1):216–223
Thorgeirsson T, Isaksson HJ, Hardardottir H et al (2010) Solitary fibrous tumors of the pleura. An estimation of population incidence[J]. Chest 137(4):1005–1006
van Houdt WJ, Westerveld CM, Vrijenhoek JE et al (2013) Prognosis of solitary fibrous tumors: a multicenter study[J]. Ann Surg Oncol 20(13):4090–4095
Funding
The authors declare that they have no funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no competing interests.
Ethics approval
This study was approved by the Ethics Committee of Shanghai chest hospital.
Informed consent
Individual written informed consent was obtained from all patients or their legal representatives, as appropriate.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Zhou, C., Li, W., Shao, J. et al. Thoracic solitary fibrous tumors: an analysis of 70 patients who underwent surgical resection in a single institution. J Cancer Res Clin Oncol 146, 1245–1252 (2020). https://doi.org/10.1007/s00432-020-03151-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00432-020-03151-8