title: Diagnosis, treatment and long-term outcome of solitary fibrous tumours of the pleura.
abstract: OBJECTIVE
  Solitary fibrous tumours of the pleura (SFTP) are rare and can histologically be differentiated into benign and malignant forms. The aim of this study is to present new cases, and discuss up-to-date preoperative examinations, the role of video-assisted thoracic surgery and long-term outcome.
  
  
  METHODS
  Between 1993 and 2006, 27 SFTPs were diagnosed (14 females, mean age+/-SD, 62.3+/-9.6 years) at our institution. Medical records were reviewed, and follow-up was obtained by repeated examinations or contact with general practitioners.
  
  
  RESULTS
  SFTPs were associated with symptoms in 63% of all cases. In the six patients in which positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) was performed preoperatively, malignant lesions were all found to be positive. Complete resection was achieved by video-assisted thoracic surgery in 15 and anterolateral thoracotomy in 12 patients. Mean hospital stay was shorter for patients operated by video-assisted thoracic surgery compared to thoracotomy, 4.5 (range 3-6) versus 7.5 (range 4-25) days, respectively (p<0.01). Histology revealed 17 benign and 10 malignant SFTP. Mean+/-SD tumour diameter of malignant SFTPs was larger than in benign forms, 11.9+/-7.1 versus 6.1+/-3.5 cm, respectively (p<0.01). Tumour recurrence was recognised in four patients with malignant SFTPs at a median time interval after surgery of 38 (range 6-122) months, two late deaths occurred resulting from tumour recurrences.
  
  
  CONCLUSIONS
  SFTPs can be treated minimally invasively by video-assisted thoracic surgery with short hospital stay. Large SFTPs with increased FDG-uptake have a high likelihood for malignancy. Long-term follow-up is mandatory in malignant SFTPs because of late recurrences associated with death.
authors.affiliation: Division of Pulmonary Medicine, University Hospital of Zurich, Switzerland. Malcolm.Kohler@orh.nhs.uk
authors.forename: Malcolm
authors.initials: M
authors.lastname: Kohler
authors.forename: Christian F
authors.initials: CF
authors.lastname: Clarenbach
authors.forename: Peter
authors.initials: P
authors.lastname: Kestenholz
authors.forename: Michael
authors.initials: M
authors.lastname: Kurrer
authors.forename: Hans C
authors.initials: HC
authors.lastname: Steinert
authors.forename: Erich W
authors.initials: EW
authors.lastname: Russi
authors.forename: Walter
authors.initials: W
authors.lastname: Weder
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018218:Neoplasms, Fibrous Tissue / Q000175:diagnosis* / Q000601:surgery; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000601:surgery; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013908:Thoracotomy / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome