Determinants of outcome of solitary fibrous tumors of the pleura: an observational cohort study

BMC Pulmonary Medicine

Malcolm Kohler¹  Walter Weder³  Rolf Stahel²  Peter Kestenholz³  Didier Schneiter³  Alex Soltermann⁴  Matthias Diebold¹  Daniel Franzen¹ 

[1] Division of Pulmonology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland;Division of Medical Oncology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland;Division of Thoracic Surgery, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland;Institute for Surgical Pathology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland

关键词: Proliferation rate;    Outcome;    Immunohistochemistry;    Pleura;    Solitary fibrous tumor;   

Others  :  1109547
DOI  :  10.1186/1471-2466-14-138

 received in 2013-12-04, accepted in 2014-08-08,  发布年份 2014

【 摘 要 】

Background

Solitary fibrous tumors of the pleura (SFTP) are rare and their long-term outcome is difficult to predict, as there are insufficient data which allow accurate characterization of the malignant variant. Thus the aim of this study was to describe the outcome and possible determinants of malignant behavior of SFTPs.

Methods

Data were collected retrospectively from medical records of patients treated at the University Hospital Zurich from 1992 to 2012. Kaplan-Meier and Cox regression analysis were performed to define disease-free survival time (defined as survival without tumor-recurrence or tumor-related death) using the classical histo-morphological criteria (tumor size, localization, pedunculation, tumor necrosis or hemorrhage, mitotic activity and nuclear pleomorphism) and immunohistochemical parameters.

Results

42 patients (20 males) with SFTP (median (IQR) age 62 (56–71) years) could be identified. SFTP were associated with symptoms in 50% of all cases. Complete resection was achieved by video-assisted thoracic surgery or thoracotomy in 20 and 22 patients, respectively. Three SFTP-related deaths (7.1%) and four tumor recurrences (9.5%) were observed. Mean disease-free survival time was 136.2 (±13.1) months, and 2-, 5- and 10-year disease-free survival was 91%, 84%, and 67%, respectively. Mean disease-free survival inversely correlated with the mean tumor diameter, number of mitotic figures and proliferation rate (Ki-67 expression). Other criteria (tumor necrosis, atypical localization, sessile tumor, and pleomorphism) were not statistically significant prognostic parameters.

Conclusions

Patients with large SFTP with a high mitotic index and high proliferation rate should be followed-up closely and over a prolonged time period in order to recognize recurrence of the SFTP early and at a treatable stage. Future research on this topic should focus on the prognostic role of immunohistochemistry including Ki-67 expression and molecular parameters.

【 授权许可】

   
2014 Franzen et al.; licensee BioMed Central Ltd.

【 图 表 】

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