Abstract
Background Solitary fibrous tumors of the pleura (SFTPs) are primary pleural tumors originating
from the mesenchymal tissue. Surgical treatment was the first choice for management
of SFTPs. There were no defined guidelines for the follow-up of these tumors and the
postoperative therapy due to the rarity of these tumors.
Methods We conducted a retrospective, multicenter study from two high-volume centers in Italy.
Data of patients diagnosed with pleural solitary fibrous tumors between January 2003
and October 2022 were prospectively recorded and retrospectively analyzed. The aim
of this study was to identify predictive prognostic factors and the correlation between
tumor characteristics and recurrence.
Results In all, 107 patients undergoing R0 surgical resection of pleural solitary fibrous
tumor were included in the study. Patients were divided in two groups: benign and
malignant. All the patients were treated with surgery with the aim to obtain R0 resection.
Lung resection was necessary when the tumor adhered strongly to the lung parenchyma
or infiltrated it. Twenty of the 107 patients had tumor recurrence. At a multivariate
analysis, histological characteristics (high mitotic index) and maximum standardized
uptake values (maxSUV) were related to recurrence. The mean disease-free survival
(DFS) was 143.3 ± 6.1 months.
Conclusion In our experience, histological features of malignancy and maxSUV are significantly
related to recurrence, which can occur even years after the first diagnosis. Surgical
excision with negative surgical margins results in good long-term outcomes. After
surgery, a long-term and strict follow-up should be done, in order to detect recurrence
early. R0 of the recurrence is associated with long-term survival.
Keywords
thoracoscopy/VATS - surgery - complications - pleural disease (including drainage)
- chest
