Department of Surgery, Section of Thoracic Surgery, Yale School of Medicine, New Haven, CT, USA.
Department of Pathology, University of California, San Francisco, USA.
Ann Surg Oncol. 2021 Sep;28(9):4953-4959. doi: 10.1245/s10434-021-09757-7. Epub 2021 Mar 16.
Solitary fibrous tumors (SFTs) are rare mesenchymal tumors most commonly arising from the pleura in the thoracic cavity. The impact of tumor size on risk of recurrence in thoracic SFTs is not well understood.
A single institution review was performed on all resected thoracic SFTs (1992-2019) with giant SFT defined as ≥ 15 cm. Clinical information, pathologic characteristics, and long-term survival data were collected, and predictors of recurrence and survival were evaluated with regression and Kaplan-Meier analysis.
There were 38 thoracic SFTs resected from patients, with the majority of tumors (n = 23, 60.5%) originating from visceral pleura. There were nine (23.7%) giant SFTs with a mean size 20.4 cm (range 17-30 cm). Mean follow-up time was 81.0 months (range 1-261 months), during which 4 of 38 (10.5%) patients experienced a recurrence within the thorax (range 51-178 months). The presence of tumor necrosis (p = 0.021) and ≥ 4 mitoses per high-powered field (p = 0.010) were associated with SFT recurrence on univariate regression. Overall 5-year, 10-year, and 20-year survival was 78.2%, 72.6%, and 42.4%, respectively, and SFT-related mortality occurred in three patients at 83, 180, and 208 months postoperatively. There were no recurrences or SFT-related mortality among patients with giant SFT.
This study represents one of the largest contemporary single institution reviews of long-term outcomes of giant thoracic SFT. Our data suggest that size is not a risk factor for recurrence in thoracic SFTs and long-term survival is excellent for giant SFTs.
孤立性纤维瘤（SFT）是一种罕见的间叶性肿瘤，最常发生于胸腔的胸膜。肿瘤大小对胸内 SFT 复发风险的影响尚不清楚。
对 1992 年至 2019 年间所有切除的胸内 SFT（n=38）进行了单机构回顾，其中巨大 SFT 定义为≥15cm。收集了临床信息、病理特征和长期生存数据，并通过回归和 Kaplan-Meier 分析评估了复发和生存的预测因素。
共切除了 38 例胸内 SFT，其中大多数肿瘤（n=23，60.5%）起源于内脏胸膜。有 9 例（23.7%）为巨大 SFT，平均大小为 20.4cm（范围 17-30cm）。平均随访时间为 81.0 个月（范围 1-261 个月），其中 38 例患者中有 4 例（10.5%）在胸内复发（范围 51-178 个月）。肿瘤坏死（p=0.021）和每高倍视野≥4 个有丝分裂（p=0.010）与 SFT 复发有关。总体 5 年、10 年和 20 年生存率分别为 78.2%、72.6%和 42.4%，3 例患者分别于术后 83、180 和 208 个月死于 SFT。巨大 SFT 患者无复发或 SFT 相关死亡。
本研究是目前对巨大胸内 SFT 长期结果进行的最大的单机构回顾之一。我们的数据表明，大小不是胸内 SFT 复发的危险因素，巨大 SFT 的长期生存率很好。
