Skip to main content
SpringerLink
Log in

Resectability, Recurrence, and Risk Stratification of Giant Solitary Fibrous Tumors in the Thoracic Cavity

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Chan JK. Solitary fibrous tumour—everywhere, and a diagnosis in vogue. Histopathology. 1997;31(6):568–76.

    Article  CAS  Google Scholar 

  2. Magdeleinat P, Alifano M, Petino A, et al. Solitary fibrous tumors of the pleura: clinical characteristics, surgical treatment and outcome. Eur J Cardio-Thoracic Surg: Off J Eur Assoc Cardio-Thoracic Surg. 2002;21(6):1087–93.

    Article  Google Scholar 

  3. de Perrot M, Fischer S, Brundler MA, Sekine Y, Keshavjee S. Solitary fibrous tumors of the pleura. Ann Thoracic Surg. 2002;74(1):285–93.

    Article  Google Scholar 

  4. England DM, Hochholzer L, McCarthy MJ. Localized benign and malignant fibrous tumors of the pleura. A clinicopathologic review of 223 cases. Am J Surg Pathol. 1989;13(8):640–58.

    Article  CAS  Google Scholar 

  5. Schirosi L, Lantuejoul S, Cavazza A, et al. Pleuro-pulmonary solitary fibrous tumors: a clinicopathologic, immunohistochemical, and molecular study of 88 cases confirming the prognostic value of de Perrot staging system and p53 expression, and evaluating the role of c-kit, BRAF, PDGFRs (alpha/beta), c-met, and EGFR. Am J Surg Pathol. 2008;32(11):1627–42.

    Article  Google Scholar 

  6. Lahon B, Mercier O, Fadel E, et al. Solitary fibrous tumor of the pleura: outcomes of 157 complete resections in a single center. Ann Thoracic Surg. 2012;94(2):394–400.

    Article  Google Scholar 

  7. Lococo F, Cesario A, Cardillo G, et al. Malignant solitary fibrous tumors of the pleura: retrospective review of a multicenter series. J Thoracic Oncol: Off Publ Int Assoc Study Lung Cancer. 2012;7(11):1698–706.

    Article  Google Scholar 

  8. Briselli M, Mark EJ, Dickersin GR. Solitary fibrous tumors of the pleura: eight new cases and review of 360 cases in the literature. Cancer. 1981;47(11):2678–89.

    Article  CAS  Google Scholar 

  9. Tapias LF, Mino-Kenudson M, Lee H, et al. Risk factor analysis for the recurrence of resected solitary fibrous tumours of the pleura: a 33-year experience and proposal for a scoring system. Eur J Cardio-Thoracic Surg: Off J Eur Assoc Cardio-Thoracic Surg. 2013;44(1):111–7.

    Article  Google Scholar 

  10. Demicco EG, Wagner MJ, Maki RG, et al. Risk assessment in solitary fibrous tumors: validation and refinement of a risk stratification model. Modern Pathol: Off J US Can Acad Pathol Inc. 2017;30(10):1433–42.

    Article  Google Scholar 

  11. Travis W, Brambilla E, Burke A, Marx A, Nicholson A. WHO classification of tumours of the lung, pleura, thymus and heart. 4th edn. Lyon: International Agency for Research on Cancer; 2015.

    Google Scholar 

  12. Tapias LF, Mercier O, Ghigna MR, et al. Validation of a scoring system to predict recurrence of resected solitary fibrous tumors of the pleura. Chest. 2015;147(1):216–23.

    Article  Google Scholar 

  13. Demicco EG, Park MS, Araujo DM, et al. Solitary fibrous tumor: a clinicopathological study of 110 cases and proposed risk assessment model. Modern Pathol: Off J US Can Acad Pathol Inc. 2012;25(9):1298–306.

    Article  Google Scholar 

  14. Salas S, Resseguier N, Blay JY, et al. Prediction of local and metastatic recurrence in solitary fibrous tumor: construction of a risk calculator in a multicenter cohort from the French Sarcoma Group (FSG) database. Ann Oncol: Off J Eur Soc Med Oncol. 2017;28(8):1979–87.

    Article  CAS  Google Scholar 

Download references

Funding

This research was funded by the University of California San Francisco Thoracic Oncology Program; no external funding or support was used.

Author information

Authors and Affiliations

  1. Department of Surgery, Section of Thoracic Surgery, Yale School of Medicine, New Haven, CT, USA

    Gavitt A. Woodard MD

  2. Department of Pathology, University of California, San Francisco, USA

    Daffolyn Rachael Fels Elliott MD, PhD & Kirk D. Jones MD

  3. Department of Surgery, Section of Thoracic Surgery, University of California, San Francisco, USA

    Ava Yap MD, Greg J. Haro MD, Johannes R. Kratz MD, Michael J. Mann MD & David M. Jablons MD

Authors
  1. Gavitt A. Woodard MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daffolyn Rachael Fels Elliott MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ava Yap MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Greg J. Haro MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Johannes R. Kratz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael J. Mann MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kirk D. Jones MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. David M. Jablons MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gavitt A. Woodard MD.

Ethics declarations

Disclosures

None of the authors have any financial relationships to disclose related to the content of this manuscript.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Woodard, G.A., Fels Elliott, D.R., Yap, A. et al. Resectability, Recurrence, and Risk Stratification of Giant Solitary Fibrous Tumors in the Thoracic Cavity. Ann Surg Oncol 28, 4953–4959 (2021). https://doi.org/10.1245/s10434-021-09757-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-021-09757-7

Search

Navigation