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Meta-Analysis
. 2021 May 27;32(6):882-888.
doi: 10.1093/icvts/ivab012.

Recurrence rates of surgically resected solitary fibrous tumours of the pleura: a systematic review and meta-analysis

Wan-Li Liu  1   2 , Wei Wu  3 , Qiong-Chuan Hong  1   2 , Kun Lv  1
Affiliations
Meta-Analysis

Recurrence rates of surgically resected solitary fibrous tumours of the pleura: a systematic review and meta-analysis

Wan-Li Liu et al. Interact Cardiovasc Thorac Surg. .

Abstract

Objectives: Recurrence rates of solitary fibrous tumours of the pleura (SFTP) after surgical resection vary widely in the published literature. Our objective was to systematically review the existing literature to determine an accurate estimate of SFTP recurrence rates after surgical resection and to determine risk factors associated with recurrence.

Methods: PubMed, EMBASE and the Cochrane library were systematically searched for randomized controlled trials and observational studies (prospective or retrospective) through 20 June 2020 that reported the recurrence rates after surgical resection. The outcome of interest was recurrence.

Results: Of the 23 included studies comparing 1262 patients, the overall recurrence of SFTP in patients who underwent surgical resection was 9% [95% confidence interval (CI) 7-12%; I2 = 52%]. In addition, pooled benign and malignant recurrence rates were 3% (95% CI 2-5%; I2 = 8%) and 22% (95% CI 15-32%; I2 = 52%), respectively. A benign SFTP was associated with a significantly lower recurrence rate than a malignant SFTP [odds ratio (OR) 0.11; 95% CI 0.06-0.20; I2 = 0%]. There was no significant difference in the recurrence rates between lesions originating from parietal versus visceral pleura (OR 1.30; 95% CI 0.28-6.02; I2 = 59%). Female sex was associated with increased recurrence (OR 5.29; 95% CI 1.66-16.92; I2 = 0%).

Conclusions: Collectively, this systematic review demonstrated a 9% SFTP post-resection recurrence rate. Furthermore, the recurrence rates for benign and malignant SFTP were 3% and 22%, respectively. Histological malignancy and female sex were associated with higher risk.

Keywords: Meta-analysis; Recurrence; Solitary fibrous tumour of the pleura.

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Figures

Figure 1:
Figure 1:
Flow diagram of literature search and screening process. E-SFT: extrapleural solitary fibrous tumour; PM: pleural mesothelioma.
Figure 2:
Figure 2:
Estimate of recurrence of solitary fibrous tumour of the pleura after surgical resection.
Figure 3:
Figure 3:
Funnel plot of recurrence rate to detect publication bias. Maximum-likelihood estimator for tau2.
Figure 4:
Figure 4:
Estimate of recurrence of benign and malignant solitary fibrous tumours of the pleura (SFTP). (A) Recurrence rate of benign SFTP and (B) recurrence rate of malignant SFTP.
Figure 5:
Figure 5:
Meta-analysis results of odds ratios for solitary fibrous tumours of the pleura. (A) Benign features versus malignant features from 10 studies; (B) origin from parietal pleura versus visceral pleura from 4 studies; (C) women versus men from 2 studies.
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