Size and location are the most important risk factors for malignant behavior in resected solitary fibrous tumors Journal Article
| Authors: | Gholami, S.; Cassidy, M. R.; Kirane, A.; Kuk, D.; Zanchelli, B.; Antonescu, C. R.; Singer, S.; Brennan, M. |
| Article Title: | Size and location are the most important risk factors for malignant behavior in resected solitary fibrous tumors |
| Abstract: | Purpose: While previously thought to be clinically indolent, recent data suggest significant late metastatic capacity of solitary fibrous tumors (SFTs). We define prognostic factors for recurrence and disease-specific death (DSD) in resected primary SFTs. Methods: Resected primary SFTs from 1982 to 2015 were identified from a prospective, single institutional database. Risk factors for local (LR) and distant recurrence (DR), and DSD were assessed using competing risk analysis. Results: A total of 219 patients with median follow-up of 6.1 (0.1–22) years were included. Five- and 10-year cumulative DSD was 9 and 11%, respectively. Size greater than the median 8 cm, gender, location, and complete gross resection were significantly associated with DSD (p < 0.05). Five- and 10-year cumulative risk (CR) of LR was 4 and 7%, whereas 5- and 10-year CR of DR was 13 and 16%, respectively. LR was associated with location (p = 0.02) and tumor size (p = 0.02), and DR was associated with size (p < 0.01). Histopathologic classification did not predict long-term behavior with both malignant and benign tumors demonstrating capacity for DR and associated death. Tumors in the thoracic cavity and abdomen/retroperitoneum presented the greatest risk of DR (16 and 27% 10-year CR). On multivariate analysis, size ≥ 8 cm (hazard ratio 2.89, p = 0.05) and tumor location in chest or abdominal/retroperitoneal cavity (hazard ratio 2.68, p = 0.01) significantly impacted DSD. Conclusions: Recurrence is highly associated with DSD and events occur as late as 16 years after initial presentation, including in patients with initially considered benign tumors. Patients with large (≥ 8 cm) tumors in the chest or abdominal/retroperitoneal cavity are at greatest risk. © 2017, Society of Surgical Oncology. |
| Keywords: | adolescent; adult; controlled study; human tissue; aged; primary tumor; major clinical study; histopathology; cancer localization; cancer recurrence; cancer risk; adjuvant therapy; cancer patient; cancer radiotherapy; follow up; antineoplastic agent; prospective study; tumor volume; cancer mortality; skin tumor; death; adjuvant chemotherapy; limb tumor; retroperitoneal tumor; solitary fibrous tumor; thorax tumor; head and neck tumor; intraoperative radiotherapy; surgical margin; trunk; disease specific death; soft tissue cancer; abdominal tumor; cancer prognosis; human; male; female; article |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 24 |
| Issue: | 13 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2017-12-01 |
| Start Page: | 3865 |
| End Page: | 3871 |
| Language: | English |
| DOI: | 10.1245/s10434-017-6092-z |
| PROVIDER: | scopus |
| PUBMED: | 29039030 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 December 2017 -- Source: Scopus |
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