Division of Thoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.
Division of Thoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.
Ann Thorac Surg. 2019 Mar;107(3):941-946. doi: 10.1016/j.athoracsur.2018.08.069. Epub 2018 Oct 23.
The objective of this study was to identify the most effective treatment for survival in patients with solitary fibrous tumors of the pleura (SFTP).
The National Cancer Database was queried for patients with malignant SFTPs. Patients were divided into two groups, those who had surgical treatment and those who did not. The primary outcome was 5-year overall survival, which was assessed by the Kaplan-Meier method and compared using the log rank test.
There were 204 patients with SFTPs identified between 2004 and 2014. Of those, 65% of patients (133) had surgical intervention, whereas 18% (37) had no surgical intervention, and 17% (34) had unknown treatment information. Among patients who underwent resection, 42% (56) had sublobar resections, 45% (60) had lobectomies, and 13% (17) had pneumonectomies. The overall 5-year survival for SFTP patients was 56%. Patients who had surgical intervention had a relative survival of 64%, and patients with no surgical intervention had 22% (p < 0.001). There was no difference in 5-year survival among patients who had sublobar resections compared with patients who had greater anatomic resections (65% versus 64%, p = 0.823).
Patients with SFTP who were managed with surgical intervention have better overall survival than patients who are not managed with surgery. Furthermore, similar 5-year survival for sublobar resections compared with greater anatomic resections suggested that the former, when possible, is sufficient.
本研究旨在确定治疗胸膜孤立性纤维瘤（SFTP）患者的最有效方法。
国家癌症数据库中检索出患有恶性 SFTP 的患者。将患者分为两组，一组接受手术治疗，另一组未接受手术治疗。主要结局是 5 年总生存率，采用 Kaplan-Meier 法评估，并通过对数秩检验进行比较。
2004 年至 2014 年间共发现 204 例 SFTP 患者。其中，65%的患者（133 例）接受了手术干预，18%（37 例）未接受手术干预，17%（34 例）治疗信息不详。在接受切除手术的患者中，42%（56 例）行亚肺叶切除术，45%（60 例）行肺叶切除术，13%（17 例）行全肺切除术。SFTP 患者的总体 5 年生存率为 56%。接受手术干预的患者相对生存率为 64%，未接受手术干预的患者生存率为 22%（p<0.001）。与行更大范围解剖性切除术的患者相比，行亚肺叶切除术的患者 5 年生存率无差异（65%比 64%，p=0.823）。
接受手术干预的 SFTP 患者总体生存率优于未接受手术治疗的患者。此外，亚肺叶切除术与更大范围解剖性切除术的 5 年生存率相似，提示前者在可能的情况下是足够的。
