Division of Otolaryngology - Head and Neck Surgery, Cooper University Health Care, Camden, NJ, USA.
Cooper Medical School of Rowan University, Camden, NJ, USA.
Head Neck Pathol. 2020 Jun;14(2):516-524. doi: 10.1007/s12105-019-01058-6. Epub 2019 Jul 23.
Solitary fibrous tumors (SFT) arising in the head and neck region are uncommon yet well-recognized entities. Their biologic behavior and management still need to be elucidated. Systematically reviewing all published cases of SFT involving the head and neck region since 1991, a pooled meta-analysis was conducted to evaluate various demographic and tumor characteristics. 587 SFT in the head and neck have been reported; 343 met pooled analysis inclusion criteria. 61% of cases presented as a new mass; 89% were painless. Median onset of symptoms prior to evaluation was 8 months. Pre-operative local invasion and malignant histological features (hemorrhage, necrosis, mitoses > 4/10 hpf) were not statistically associated with decreased recurrence-free survival. Positive surgical margins was the only factor associated with shorter recurrence-free survival (p < 0.001). The evidence presented herein reveals novel associations between clinical presentation and tumor characteristics that provide otolaryngologists with new insight into SFT tumor behavior, thus prompting further investigations.
头颈部孤立性纤维瘤（SFT）较为少见，但已被广泛认识。其生物学行为和治疗方案仍有待阐明。本研究对 1991 年以来发表的所有涉及头颈部的 SFT 病例进行了系统回顾，并进行了荟萃分析，以评估各种人口统计学和肿瘤特征。共报道了 587 例头颈部 SFT，其中 343 例符合荟萃分析纳入标准。61%的病例表现为新出现的肿块；89%的病例无疼痛。评估前症状的中位发病时间为 8 个月。术前局部侵犯和恶性组织学特征（出血、坏死、有丝分裂象>4/10 hpf）与无复发生存率降低无统计学关联。切缘阳性是与无复发生存率降低相关的唯一因素（p<0.001）。本研究结果揭示了临床表现与肿瘤特征之间的新关联，为耳鼻喉科医生提供了对 SFT 肿瘤行为的新认识，从而促使进一步的研究。
