Background Solitary fibrous tumors of the pleura (SFTPs) are primary pleural tumors originating from the mesenchymal tissue. Surgical treatment was the first choice for management of SFTPs. There were no defined guidelines for the follow-up of these tumors and the postoperative therapy due to the rarity of these tumors. Methods We conducted a retrospective, multicenter study from two high-volume centers in Italy. Data of patients diagnosed with pleural solitary fibrous tumors between January 2003 and October 2022 were prospectively recorded and retrospectively analyzed. The aim of this study was to identify predictive prognostic factors and the correlation between tumor characteristics and recurrence. Results In all, 107 patients undergoing R0 surgical resection of pleural solitary fibrous tumor were included in the study. Patients were divided in two groups: benign and malignant. All the patients were treated with surgery with the aim to obtain R0 resection. Lung resection was necessary when the tumor adhered strongly to the lung parenchyma or infiltrated it. Twenty of the 107 patients had tumor recurrence. At a multivariate analysis, histological characteristics (high mitotic index) and maximum standardized uptake values (maxSUV) were related to recurrence. The mean disease-free survival (DFS) was 143.3 ± 6.1 months. Conclusion In our experience, histological features of malignancy and maxSUV are significantly related to recurrence, which can occur even years after the first diagnosis. Surgical excision with negative surgical margins results in good long-term outcomes. After surgery, a long-term and strict follow-up should be done, in order to detect recurrence early. R0 of the recurrence is associated with long-term survival.

中文翻译：

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胸膜孤立性纤维瘤：手术治疗和复发

背景 胸膜孤立性纤维瘤（SFTP）是起源于间叶组织的原发性胸膜肿瘤。手术治疗是 SFTP 治疗的首选。由于这些肿瘤的罕见性，对于这些肿瘤的随访和术后治疗没有明确的指南。方法 我们对意大利的两个大容量中心进行了一项回顾性多中心研究。前瞻性记录并回顾性分析2003年1月至2022年10月诊断为胸膜孤立性纤维瘤的患者数据。本研究的目的是确定预测预后因素以及肿瘤特征与复发之间的相关性。结果 本研究共纳入 107 例接受 R0 胸膜孤立性纤维瘤手术切除的患者。患者被分为两组：良性和恶性。所有患者均接受手术治疗，目标是获得R0切除。当肿瘤与肺实质紧密粘附或浸润时，需要进行肺切除。107 名患者中有 20 名出现肿瘤复发。在多变量分析中，组织学特征（高有丝分裂指数）和最大标准化摄取值（maxSUV）与复发相关。平均无病生存期 (DFS) 为 143.3 ± 6.1 个月。结论 根据我们的经验，恶性肿瘤的组织学特征和 maxSUV 与复发显着相关，甚至可能在首次诊断数年后发生。手术切缘阴性的手术切除可以获得良好的长期结果。手术后应进行长期、严格的随访，以便及早发现复发。复发的 R0 与长期生存相关。