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胸膜孤立性纤维瘤的手术治疗:现有证据综述

Surgery for Solitary Fibrous Tumors of the Pleura: A Review of the Available Evidence.

作者信息

Bertoglio Pietro, Querzoli Giulia, Kestenholz Peter, Scarci Marco, La Porta Marilina, Solli Piergiorgio, Minervini Fabrizio

机构信息

Division of Thoracic Surgery, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40100 Bologna, Italy.

Alma Mater Studiorum, University of Bologna, 40064 Bologna, Italy.

出版信息

Cancers (Basel). 2023 Aug 18;15(16):4166. doi: 10.3390/cancers15164166.

Abstract

Solitary fibrous tumors of the pleura (pSFT) are a relatively rare neoplasms that can arise from either visceral or parietal pleura and may have different aggressive biological behaviors. Surgery is well known to be the cornerstone of the treatment for pSFT. We reviewed the existing literature, focusing on the role of surgery in the management and treatment of pSFT. All English-written literature has been reviewed, focusing on those reporting on the perioperative management and postoperative outcomes. Surgery for pSFT is feasible and safe in all experiences reported in the literature, but surgical approaches and techniques may vary according to the tumor dimensions, localization, and surgeons' skills. Long-term outcomes are good, with a 10-year overall survival rate of more than 70% in most of the reported experiences; on the other hand, recurrence may happen in up to 17% of cases, which occurs mainly in the first two years after surgery, but case reports suggest the need for a longer follow-up to assess the risk of late recurrence. Malignant histology and dimensions are the most recognized risk factors for recurrence. Recurrence might be operated on in select patients. Surgery is the treatment of choice in pSFT, but a radical resection and a careful postoperative follow-up should be carried out.

摘要

胸膜孤立性纤维瘤(pSFT)是一种相对罕见的肿瘤,可起源于脏层或壁层胸膜,且可能具有不同的侵袭性生物学行为。众所周知,手术是pSFT治疗的基石。我们回顾了现有文献,重点关注手术在pSFT管理和治疗中的作用。我们查阅了所有英文撰写的文献,重点关注那些报告围手术期管理和术后结果的文献。文献报道的所有经验均表明,pSFT手术是可行且安全的,但手术方式和技术可能因肿瘤大小、位置以及术者技能而有所不同。长期预后良好,在大多数报道的经验中,10年总生存率超过70%;另一方面,高达17%的病例可能会复发,主要发生在术后的头两年,但病例报告表明需要更长时间的随访以评估晚期复发风险。恶性组织学类型和肿瘤大小是最公认的复发危险因素。部分患者复发后可再次手术。手术是pSFT的首选治疗方法,但应进行根治性切除并仔细进行术后随访。

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