Published in:
Open Access
01-12-2015 | Research
Retroperitoneal solitary fibrous tumor: surgery as first line therapy
Authors:
Rahul Rajeev, Mohit Patel, Thejus T. Jayakrishnan, Fabian M. Johnston, Meena Bedi, John Charlson, Kiran K. Turaga
Published in:
Clinical Sarcoma Research
|
Issue 1/2015
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Abstract
Background
Solitary fibrous tumors (SFT) of the retroperitoneum are rare spindle cell neoplasms, with a paucity of data on treatment outcomes. We hypothesized that surgical excision offered acceptable outcomes in SFTs.
Methods
The National Cancer Database (NCDB) was used to identify patients with SFT from 2004 to 2011. Primary outcome measures were 30 day mortality and overall survival. Descriptive analyses were performed. Furthermore, a systematic review of published literature was conducted after creating a pre-specified search strategy.
Results
Of 51 patients in the NCDB, 58.8 % (n = 30) were males, with a median age 60 years (IQR 49–72 years). Median tumor size was 16 cm (IQR 11–21 cm). Surgical resection was performed in 92.2 % (n = 47) with 63.8 % (n = 30) having a margin negative resection. Peri-operative mortality was 2.1 % (n = 1). Of survival outcomes available for 18 patients, the median OS was 51.1 months. From the systematic review, we identified 8 studies, with 24 patients. Median age and tumor size was similar to the NCDB [47.5 years (IQR 39–66.5 years), 12 cm (IQR 7–17 cm)]. Majority [91.7 % (n = 22)] underwent surgical excision alone while one received adjuvant chemotherapy and none received radiation. After median follow up of 54 months (IQR 28–144 months), 79.2 % (n = 19) were alive without disease. Three patients (12.5 %) died of disease, one was alive with disease and one was lost to follow up. Recurrence was reported in 16.7 % (n = 4) of patients.
Conclusion
Complete surgical excision is a viable treatment modality for retroperitoneal SFT leading to long term survival. Low recurrence rates would argue against the need for routine adjuvant radiation or chemotherapy.