Resectable extra-pleural and extra-meningeal solitary fibrous tumours

A multi-centre prognostic study

S. Pasquali, Alessandro Gronchi, Dirk C. Strauss, Sylvie Bonvalot, L. Jeys, Silvia Stacchiotti, Andrew J. Hayes, Charles Honore, Paola Collini, Salvatore Lorenzo Renne, N. Alexander, Robert Grimer, D. Callegaro, V. P. Sumathi, David Gourevitch, Anant Desai

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalEuropean Journal of Surgical Oncology
DOIs
Publication statusAccepted/In press - 2016

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Meningeal Neoplasms
Solitary Fibrous Tumors
Recurrence
Sarcoma
Mitosis
Disease-Free Survival
Neoplasms
Necrosis
Referral and Consultation
Survival

Keywords

  • Haemangiopericytoma
  • Prognosis
  • Sarcoma
  • Solitary fibrous tumour

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Resectable extra-pleural and extra-meningeal solitary fibrous tumours : A multi-centre prognostic study. / Pasquali, S.; Gronchi, Alessandro; Strauss, Dirk C.; Bonvalot, Sylvie; Jeys, L.; Stacchiotti, Silvia; Hayes, Andrew J.; Honore, Charles; Collini, Paola; Renne, Salvatore Lorenzo; Alexander, N.; Grimer, Robert; Callegaro, D.; Sumathi, V. P.; Gourevitch, David; Desai, Anant.

In: European Journal of Surgical Oncology, 2016.

Research output: Contribution to journalArticle

Pasquali, S, Gronchi, A, Strauss, DC, Bonvalot, S, Jeys, L, Stacchiotti, S, Hayes, AJ, Honore, C, Collini, P, Renne, SL, Alexander, N, Grimer, R, Callegaro, D, Sumathi, VP, Gourevitch, D & Desai, A 2016, 'Resectable extra-pleural and extra-meningeal solitary fibrous tumours: A multi-centre prognostic study', European Journal of Surgical Oncology. https://doi.org/10.1016/j.ejso.2016.01.023
Pasquali, S. ; Gronchi, Alessandro ; Strauss, Dirk C. ; Bonvalot, Sylvie ; Jeys, L. ; Stacchiotti, Silvia ; Hayes, Andrew J. ; Honore, Charles ; Collini, Paola ; Renne, Salvatore Lorenzo ; Alexander, N. ; Grimer, Robert ; Callegaro, D. ; Sumathi, V. P. ; Gourevitch, David ; Desai, Anant. / Resectable extra-pleural and extra-meningeal solitary fibrous tumours : A multi-centre prognostic study. In: European Journal of Surgical Oncology. 2016.
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abstract = "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.",
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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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