Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY 14642, USA.
J Thorac Dis. 2011 Jun;3(2):99-104. doi: 10.3978/j.issn.2072-1439.2011.01.04.
This study characterizes the overall survival (OS) and cause specific survival (CSS) of patients with thoracic malignant solitary fibrous tumors.
Eighty-two patients with malignant solitary fibrous tumors of the lung, pleura or mediastinum, diagnosed from 2001-2007, were retrospectively analyzed using the population-based Surveillance, Epidemiology, and End Results database.
Among 77 patients with available staging information, 42% (n=32) had localized disease, 31% (n=24) had regional disease extension (without nodal involvement) and 27% had regional-nodal (n=2) or distant (n=19) metastases. Cancer-directed surgery was performed in 85%; radiation was performed in 16%. The 1-year, 5-year and median OS were 87%, 49% and 4.6 years respectively. The 1-year, 5-year and median CSS were 89%, 61% and 5.7 years respectively. Less advanced stage and undergoing cancer-directed surgery were favorable prognostic factors. For localized, regional and distant stage the median OS was: not reached at 6.3 years, 4.4 years and 2.0 years respectively (P=0.021); the median CSS was not reached at 6.3 years, 5.0 years and 2.4 years (P=0.068). For patients undergoing versus not undergoing surgery, the median OS was 4.9 vs 0.9 years (P=0.053) and median CSS was 5.7 vs 0.9 years (P=0.011). Tumor size was not significant.
From a population-based analysis of patients with thoracic malignant solitary fibrous tumors, stage and cancer-directed surgery had the greatest impact on OS and CSS. While being amenable to surgery likely reflects more indolent disease and/or better performance status and cardiopulmonary function, the significantly favorable impact of surgery also likely reflects a therapeutic benefit.
本研究旨在描述胸部恶性孤立性纤维瘤患者的总生存期（OS）和特异性生存期（CSS）。
回顾性分析了 2001 年至 2007 年间诊断为肺、胸膜或纵隔恶性孤立性纤维瘤的 82 例患者的资料，这些患者的资料来源于人群基础的监测、流行病学和最终结果数据库。
在 77 例具有可获得分期信息的患者中，42%（n=32）为局限性疾病，31%（n=24）为区域性疾病扩展（无淋巴结受累），27%为区域性淋巴结（n=2）或远处（n=19）转移。85%的患者接受了癌症定向手术；16%的患者接受了放疗。1 年、5 年和中位 OS 分别为 87%、49%和 4.6 年。1 年、5 年和中位 CSS 分别为 89%、61%和 5.7 年。较晚的分期和接受癌症定向手术是有利的预后因素。局限性、区域性和远处分期患者的中位 OS 分别为：未达到的 6.3 年、4.4 年和 2.0 年（P=0.021）；中位 CSS 分别为未达到的 6.3 年、5.0 年和 2.4 年（P=0.068）。对于接受手术与未接受手术的患者，中位 OS 分别为 4.9 年和 0.9 年（P=0.053），中位 CSS 分别为 5.7 年和 0.9 年（P=0.011）。肿瘤大小无显著意义。
从人群基础上对胸部恶性孤立性纤维瘤患者的分析中可以看出，分期和癌症定向手术对 OS 和 CSS 的影响最大。虽然手术的可行性可能反映了疾病更具惰性，或更好的身体状态和心肺功能，但手术的显著有利影响也可能反映了治疗的益处。
