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

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.

Keywords: Malignant solitary fibrous tumor; Recurrence; Solitary fibrous tumor; Surgical resection.

MeSH terms

  • Adult
  • Aged
  • Esophageal Neoplasms / diagnostic imaging
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery
  • Female
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / pathology
  • Pleural Neoplasms / diagnostic imaging
  • Pleural Neoplasms / pathology
  • Pleural Neoplasms / surgery
  • Retrospective Studies
  • Thoracic Neoplasms / diagnostic imaging
  • Thoracic Neoplasms / pathology
  • Thoracic Neoplasms / surgery*