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胸腔孤立性纤维瘤:单中心 70 例手术切除患者的分析。

Thoracic solitary fibrous tumors: an analysis of 70 patients who underwent surgical resection in a single institution.

机构信息

Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.

Department of Pathology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China.

出版信息

J Cancer Res Clin Oncol. 2020 May;146(5):1245-1252. doi: 10.1007/s00432-020-03151-8. Epub 2020 Feb 14.

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.

摘要

背景

胸部长孤立性纤维瘤(TSFT)是一种少见的间叶源性肿瘤。目前关于其手术治疗效果和预后因素的数据较为缺乏。本回顾性研究旨在分析 TSFT 的手术治疗效果、临床特点和预后。

方法

回顾性分析 2008 年 8 月至 2014 年 10 月期间在我科接受手术切除的 70 例 TSFT 患者的临床资料。

结果

共纳入 70 例 TSFT 患者(58 例良性,12 例恶性),除 1 例初始治疗后复发的患者外,所有患者均接受了完全手术切除。TSFT 起源于胸膜(n=43)、肺(n=9)、纵隔(n=16)、食管(n=1)和膈肌(n=1)。29 例患者仅行肿块切除术,41 例患者行整块切除术包括周围结构。随访期间,良性 TSFT 患者无肿瘤复发。6 例恶性患者均复发,其中 5 例因局部复发和远处转移死亡。中位随访时间为 95 个月(范围 3-133 个月)。TSFT 患者的 5 年总生存率(OS)为 94.3%。恶性 TSFT 患者的 5 年无复发生存率和 OS 分别为 58.3%和 66.7%。

结论

TSFT 的治疗金标准是完全手术切除。对于选择合适的 TSFT 患者,VATS 是安全可靠的。对于局部复发或单发转移瘤的患者,可进行积极的手术切除。由于有复发的风险,需要进行长期随访。

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