TY - JOUR
T1 - Resectable extra-pleural and extra-meningeal solitary fibrous tumours
T2 - A multi-centre prognostic study
AU - Pasquali, S.
AU - Gronchi, Alessandro
AU - Strauss, Dirk C.
AU - Bonvalot, Sylvie
AU - Jeys, L.
AU - Stacchiotti, Silvia
AU - Hayes, Andrew J.
AU - Honore, Charles
AU - Collini, Paola
AU - Renne, Salvatore Lorenzo
AU - Alexander, N.
AU - Grimer, Robert
AU - Callegaro, D.
AU - Sumathi, V. P.
AU - Gourevitch, David
AU - Desai, Anant
PY - 2016
Y1 - 2016
N2 - Background: Extra-pleural and extra-meningeal solitary fibrous tumour (SFT) is a rare sarcoma histotype curable with surgery in the majority of patients. The behaviour of these tumours ranges from indolent/very low grade to malignant/high grade but it is still not possible to accurately predict prognosis after surgery. We have investigated a multi-centre series to stratify the risk of recurrence to patients with SFTs. Methods: We retrospectively analysed the data from 243 patients who underwent surgery (2002-2011) at four sarcoma referral centres. Results: Upon univariate analysis, hypercellularity, atypia, necrosis, high mitotic rate (ie >4 mitoses/10 HPF) were associated with both disease-free and overall survival. Surgical margins were a significant prognostic factor for disease-free (P = 0.007) but not for overall survival. Unexpectedly, larger tumour size was associated with a better prognosis (P = 0.038) and fewer recurrences (P = 0.024). Upon multivariable analysis, high mitotic rate (hazard ratio, HR = 2.85, P = 0.002), cellular atypia (HR = 1.62, P = 0.015) and hypercellularity (HR = 1.82, P = 0.031) were significantly associated with recurrences. A SFT recurrence score has been provided to stratify risk of recurrence. Conclusion: This study provides a prognostic model to stratify risk of recurrence in patients with resectable SFTs. This allows clinician to decide on an optimal follow-up strategy and to select patients that may benefit from adjuvant treatments.
AB - Background: Extra-pleural and extra-meningeal solitary fibrous tumour (SFT) is a rare sarcoma histotype curable with surgery in the majority of patients. The behaviour of these tumours ranges from indolent/very low grade to malignant/high grade but it is still not possible to accurately predict prognosis after surgery. We have investigated a multi-centre series to stratify the risk of recurrence to patients with SFTs. Methods: We retrospectively analysed the data from 243 patients who underwent surgery (2002-2011) at four sarcoma referral centres. Results: Upon univariate analysis, hypercellularity, atypia, necrosis, high mitotic rate (ie >4 mitoses/10 HPF) were associated with both disease-free and overall survival. Surgical margins were a significant prognostic factor for disease-free (P = 0.007) but not for overall survival. Unexpectedly, larger tumour size was associated with a better prognosis (P = 0.038) and fewer recurrences (P = 0.024). Upon multivariable analysis, high mitotic rate (hazard ratio, HR = 2.85, P = 0.002), cellular atypia (HR = 1.62, P = 0.015) and hypercellularity (HR = 1.82, P = 0.031) were significantly associated with recurrences. A SFT recurrence score has been provided to stratify risk of recurrence. Conclusion: This study provides a prognostic model to stratify risk of recurrence in patients with resectable SFTs. This allows clinician to decide on an optimal follow-up strategy and to select patients that may benefit from adjuvant treatments.
KW - Haemangiopericytoma
KW - Prognosis
KW - Sarcoma
KW - Solitary fibrous tumour
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U2 - 10.1016/j.ejso.2016.01.023
DO - 10.1016/j.ejso.2016.01.023
M3 - Article
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
ER -