İntratorasik Soliter Fibröz Tümör Nedeniyle Opere Edilen Hastaların Uzun Dönem Onkolojik Sonuçlarının Değerlendirilmesi

Year 2022, Volume: 1 Issue: 2, 56 - 63, 27.09.2022

Celal Buğra Sezen , Gamze Tanrıkulu , Ayşegül Çiftçi , Dilekhan Kizir , Özkan Saydam , Muzaffer Metin

Abstract

Giriş:
Soliter fibröz tümör (SFT), tüm yumuşak doku tümörlerinin %2'sinden daha azını oluşturan mezenkimal kökenli nadir bir tümördür. Çalışmamız, soliter fibröz tümör nedeniyle opere ettiğimiz hastaların erken ve uzun dönem sonuçlarını literatür eşliğinde değerlendirmektedir. Gereç ve Yöntemler:
Ocak 2011 ve Aralık 2021 tarihleri arasında SFT nedeniyle opere edilen 21 hasta retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, morbidite ve mortaliteleri , sağkalım sonuçları çalışmada değerlendirildi.
Bulgular:
Çalışmadaki hastaların 16 (%76.2)’si benign, 5’i (%23.8)ise malign karakterde idi. On sekiz hastanın (%85,7) plevral soliter fibröz tümörü mevcut iken, 3 hastanın (%14,3) ekstraplevral soliter fibröz tümörü vardı. Benign hastalarda, 10 cm ve üzerinde tümör çapı olan 7 hasta (%43.8) varken; malign grupta 3 hasta (%60) yer almaktaydı (p=0.635). Hastaların ortalama takip süresi 58,7 ay; SFT’li hastaların ortalama sağkalım süresi 102 aydır (%95 CI: 85-120). İki yıllık sağkalım süresi %100, 5 yıllık sağkalım süresi ise %79 olarak izlenmiştir. Grup 1 hastalarda 2 yıllık sağkalım oranı %100 iken 5 yıllık sağkalım %90 saptanmış olup; grup 2 de bu oranlar sırasıyla %53,3 ve %53.3’tür. Tümör çapı 10 cm ve altında olan hastalarda 5 yıllık sağkalım %85,7 iken, 10 cm ve altında %72,9 olarak saptanmıştır (p=0.494).
Sonuç: Benign soliter fibröz tümörlerde komplet cerrahi tedavi hastalığın nüksünü engellemektedir. Ancak malign fibröz tümörlerde hastaların takibi oldukça önemlidir.

Keywords

Soliter Fibröz Tümör, Cerrahi prosedürler, Torakotomi

Supporting Institution

Yok

Prognostic Factors Affecting Early and Long-Term Outcomes in Solitary Fibrous Tumors?

Abstract

Background:
A solitary fibrous tumor (SFT) is a rare tumor of mesenchymal origin, accounting for less than 2% of all soft tissue tumors. Our study evaluates the early and long-term outcomes of patients operated for solitary fibrous tumors in the light of the literature.
Material and Method:
Twenty-one patients who were operated on for SFT between January 2011 and December 2021 were evaluated retrospectively. Demographic characteristics, morbidity, mortality, and survival results of the patients were evaluated in the study.
Results:
Of the patients in the study, 16 (76.2%) were benign, and 5 (23.8%) were malignant. Eighteen patients (85.7%) had pleural solitary fibrous tumors, while 3 patients (14.3%) had extrapleural solitary fibrous tumors. In benign patients, there were 7 patients (43.8%) with a tumor diameter of 10 cm or more; There were 3 patients (60%) in the malignant group (p=0.635). The mean follow-up period of the patients was 58.7 months; The mean survival time of patients with PFT is 102 months (95% CI: 85-120). The two-year survival rate was 100%, and the 5-year survival rate was 79%. While the 2-year survival rate was 100% in Group 1 patients, the 5-year survival was 90%; In group 2, these rates are 53.3% and 53.3%, respectively. In patients with a 10 cm or less tumor diameter, 5-year survival was 85.7%, while it was 72.9% under 10 cm (p=0.494).
Conclusion: Complete surgical treatment in benign solitary fibrous tumors prevents the recurrence of the disease. However, follow-up of patients in malignant fibrous tumors is crucial.

Keywords

Solitary Fibrous Tumor, Surgery, Thoracotomy

References

• 1.Wagner E. Das tuberkelahnliche lymphadenom (der cytogene oder reticulirte tuberkel). Arch Heilk (Leipig) 1870;11:497.
• 2. Ronchi A, Cozzolino I, Marino FZ, Accardo M, Montella M, Panarese I et al. Extrapleural solitary fibrous tumor: a distinct entity from pleural solitary fibrous tumor. An update on clinical, molecular and diagnostic features. Ann Diagn Pathol. 2018;34:142-50.
• 3.Gürsoy S, Yoldaş B, Üçvet A, Usluer O, Yazgan S, Dinç ZA. Solitary fibrous tumours, should they always considered to be benign gigantic masses? Curr Thorac Surg. 2017;2:15-9.
• 4.Attanoos RL, Pugh MR. The diagnosis of pleural tumors other than mesothelioma. Arch Pathol Lab Med. 2018;142:902-13.
• 5.Batırel HF, Demirhana R. Plevranın soliter fibröz tümörü. TTD Plevra Bül. 2010;4:13-6.
• 6.Demicco EG, Wagner MJ, Maki RG, Gupta V, Lofin I, Lazar AJ et al. Risk assessment in solitary fibrous tumors: validation and refinement of a risk stratification model. Mod Pathol. 2017;30:1433-42.
• 7.Mercer RM, Wigston C, Banka R, Cardillo G, Benamore R, Nicholson A et al. Management of solitary fibrous tumours of the pleura: a systematic review and meta-analysis. ERJ Open Res. 2020;6:00055-02020.
• 8.Cardillo G, Carbone L, Carleo F, Masala N, Graziano P, Bray A et al. Solitary fibrous tumors of the pleura: an analysis of 110 patients treated in a single institution. Ann Thorac Surg. 2009;88:1632-7.
• 9.Harrison–Phipps KM, Nichols FC, Schleck CD, Deschamps C, Cassivi SD, Schipper PH et al. Solitary fibrous tumors of the pleura: results of surgical treatment and long-term prognosis. J Thorac Cardiovasc Surg. 2009;138:19-25.
• 10.Beddhu S, Bruns FJ, Saul M, Seddon P, Zeidel ML. A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients. Am J Med. 2000;108: 609-13.
• 11.Huang S, Li C, Kao Y, Chuang IC, Tai HC, Tsai JW et al. The clinicopathological significance of NAB2-STAT 6 gene fusions in 52 cases of intrathoracic solitary fibrous tumors. Cancer Med. 2016;5:159-68.
• 12.Ge W, Yu DC, Chen G, Ding YT. Clinical analysis of 47 cases of solitary fibrous tumor. Oncol Lett. 2016;12:2475-80.
• 13.Marak CP, Dorokhova O, Guddati AK. Solitary fibrous tumor of the pleura. Med Oncol. 2013;30:1-6.
• 14.Magdeleinat P, Alifano M, Petino A, Le Rochais JP, Dulmet E, Galateau F et al. Solitary fibrous tumors of the pleura: clinical characteristics, surgical treatment and outcome. Eur J Cardiothorac Surg. 2002;21: 1087-93.
• 15.Savu C, Melinte A, Posea R,Galie N, Balescu I, Diaconu C et al. Pleural solitary fibrous tumors—A retrospective study on 45 patients. Medicina (Mex). 2020;56:185.
• 16.Lahon B, Mercier O, Fadel E, Ghigna MR, Petkova B, Mussot S et al. Solitary fibrous tumor of the pleura: Outcomes of 157 complete resections in a single center. Ann Thorac Surg. 2012;94:394-400.
• 17.Abu Arab W. Solitary fibrous tumours of the pleura. Eur J Cardiothorac Surg. 2012;41:587-97.
• 18.McGuire A, Villeneuve PJ, Sekhon H, Gilbert S, Sundaresan S, Maziak DE et al. Predictors of malignant pathology and the role of trans-thoracic needle biopsy in management of solitary fibrous tumors of the pleura: a 30-year review of a tertiary care center patient cohort. Open J Thorac Surg. 2016;6:57.