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. 2009 Jul;138(1):19-25.
doi: 10.1016/j.jtcvs.2009.01.026.

Solitary fibrous tumors of the pleura: results of surgical treatment and long-term prognosis

Karen M Harrison-Phipps  1 , Francis C Nichols, Cathy D Schleck, Claude Deschamps, Stephen D Cassivi, Paul H Schipper, Mark S Allen, Dennis A Wigle, Peter C Pairolero
Affiliations

Solitary fibrous tumors of the pleura: results of surgical treatment and long-term prognosis

Karen M Harrison-Phipps et al. J Thorac Cardiovasc Surg. 2009 Jul.

Abstract

Objective: We sought to define the long-term outcome of surgically treated solitary fibrous tumors of the pleura.

Methods: We performed a retrospective review from December 1972 through December 2002.

Results: There were 84 patients (39 men and 45 women) with a median age of 57 years (range, 34-83 years). Forty-six patients were symptomatic. Surgical resection included pulmonary wedge excision in 62 patients, lobectomy in 4 patients, segmentectomy in 2 patients, chest wall resection in 3 patients, isolated pleural resection in 7 patients, and chest wall resection with pulmonary wedge excision, lobectomy, or pneumonectomy in 3, 2, and 1 patients, respectively. Tumors were polypoid in 57 patients, sessile in 20 patients, and intrapulmonary in 7 patients. Histopathology was benign in 73 and malignant in 11 patients. Nine (82%) patient with malignant tumors and 37 (54%) patients with benign tumors were symptomatic (P = .11). The median tumor diameters for malignant and benign tumors were 12.0 and 4.5 cm, respectively (P = .001). Operative mortality and morbidity occurred in 3 (3.6%) and 7 (8.1%) patients, respectively. Median follow-up in survivors was 146 months (range, 23-387 months). Median survival for patients with benign and malignant tumors was 284 and 55 months, respectively, and 5-year survival was 88.9% and 45.5%, respectively (P = .0005). Eight (9.5%) patients had recurrent solitary fibrous tumors of the pleura. Recurrences were malignant in 6 and benign in 2 patients. Localized chest recurrences occurred in 3 patients, all of whom had reresection, with 2 patients again having recurrence.

Conclusion: Resection of benign solitary fibrous tumors of the pleura carries an excellent prognosis. Larger tumors are more likely to be malignant. Both benign and malignant tumors can recur. Although prolonged survival after resection of malignant tumors is possible, recurrence is common.

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Figures

FIGURE 1
FIGURE 1
Overall survival (death from any cause) of 84 patients undergoing resection of solitary fibrous tumors of the pleura. Zero time on the abscissa is the date of the operation. Numbers of patients at risk are shown below the abscissa.
FIGURE 2
FIGURE 2
Survival (death from any cause) in 73 patients who underwent resection of benign solitary fibrous tumors of the pleura compared with that in 11 patients who had resection of malignant solitary fibrous tumor. Zero time on the abscissa is the date of the operation. Numbers of patients at risk are shown below the abscissa.
FIGURE 3
FIGURE 3
Survival (death from any cause) free of recurrence in 73 patients who underwent resection of benign solitary fibrous tumors of the pleura compared with that in 11 patients who had resection of malignant solitary fibrous tumors. Zero time on the abscissa is the date of the operation. Numbers of patients at risk are shown below the abscissa.
FIGURE 4
FIGURE 4
Computed tomographic scan showing a small solitary fibrous tumor of the visceral pleura.
FIGURE 5
FIGURE 5
Computed tomographic scan showing a giant solitary fibrous tumor of the pleura. It appears somewhat inhomogeneous.
See this image and copyright information in PMC

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