RT Journal Article
SR Electronic
T1 Management of solitary fibrous tumours of the pleura: a systematic review and meta-analysis
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00055-2020
DO 10.1183/23120541.00055-2020
VO 6
IS 3
A1 Rachel M. Mercer
A1 Charlotte Wigston
A1 Radhika Banka
A1 Giuseppe Cardillo
A1 Rachel Benamore
A1 Andrew G. Nicholson
A1 Rachelle Asciak
A1 Maged Hassan
A1 Robert J. Hallifax
A1 Louise Wing
A1 Eihab O. Bedawi
A1 Nick A. Maskell
A1 Elinor K. Harriss
A1 Robert F. Miller
A1 Najib M. Rahman
YR 2020
UL http://openres.ersjournals.com/content/6/3/00055-2020.abstract
AB Background Solitary fibrous tumours of the pleura (SFTP), or pleural fibromas, are rare tumours that generally, but not universally, follow a benign course. Surgical resection is the standard treatment, but there are no evidence-based guidelines regarding the management of these tumours.Methods Five databases were searched from inception to April 1, 2019 for studies reporting on SFTP management.Results Twenty-seven studies met the inclusion criteria (1542 patients, all non-comparative case series); 98% of these patients underwent resection and all SFTP included were pathologically diagnosed. 394 out of 1299 cases (30.5%, 95% CI 27.8–32.8%) were malignant with recurrence rates of between 0% and 42.9%. A pleural effusion was always associated with a negative outcome, but no other features were consistently reported to have negative associations. Preoperative biopsies incorrectly reported malignant histology in two studies. Over 25% of cases of recurrence occurred when a complete (R0) resection had been achieved. The first recurrence occurred >5 years after the initial resection in at least 23% of cases.Conclusions There is strong evidence to support long-term surveillance after surgical resection of SFTP, even where a complete (R0) resection has been achieved; however, there is no clear evidence to inform clinicians regarding the selection of patients who should undergo resection. The rates of malignant SFTP and SFTP recurrence are higher than previously reported. Only those that were pathologically diagnosed or resected were included, which may bias the data towards more aggressive tumours. Data collection on radiologically diagnosed SFTP is required to draw conclusions regarding the timing and need for intervention.Long-term surveillance should be undertaken after a resection of solitary fibrous tumours of the pleura but further work is needed to determine which patients are likely to follow a malignant clinical course to decide timing and necessity of a resection https://bit.ly/2U10SaA