title: Assessing the multimodal management of advanced solitary fibrous tumors of the pleura in a routine practice setting.
abstract: BACKGROUND
  Solitary fibrous tumors of the pleura (SFTP) refer as to a heterogeneous group of mesenchymal malignancies with various anatomic and histology features. Upfront surgical resection is the standard approach, but recurrences may be aggressive and difficult to treat. The most widely accepted staging system has been proposed by De Perrot et al. Because SFTPs are rare, evidence to support a role for perioperative chemotherapy is scarce. Likewise, the predictive or prognostic relevance of the De Perrot system may be questioned.
  
  
  METHODS
  Multicenter retrospective study of patients with histologically proven SFTP with complete follow-up from surgical diagnostic to tumor recurrence and death.
  
  
  RESULTS
  Sixty-eight patients were included. Tumor stage was 0/I for 29 (43%) patients, II for 23 (34%) patients, III for seven (10%) patients, and IV for nine (13%) patients. Postoperative chemotherapy was given to seven patients, mostly with stage III/IV SFTP, mostly consisting of doxorubicin-based regimen. Recurrence rate and median relapse-free survival after surgery were 3%, 52%, 71%, and 80% (p < 0.001), and 107, 70, 29, 11 months (p < 0.001) for stage 0/I, II, III, and IV tumors, respectively. At time of tumor recurrence, 14 patients received exclusive chemotherapy. Highest disease control rates were observed with trabectedin, and gemcitabine-dacarbazine combination.
  
  
  CONCLUSIONS
  Our study confirms the prognostic value of the De Perrot staging system, as well as its possible predictive value for perioperative chemotherapy decision-making, whereas the efficacy of currently available regimens to significantly reduce the risk of tumor recurrence remains questionable. Trabectedin may be of interest for recurrent tumors.
authors.affiliation: *Respiratory Medicine Service, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France; †Respiratory Medicine Service, Hôpital Larrey, CHU de Toulouse, Université de Toulouse III (Paul Sabatier), Toulouse, France; ‡Department of Medicine, Leon Bérard Cancer Center, Lyon, France; §Pathology Department, Hospices Civils de Lyon, Lyon, France; ║Thoracic Surgery Department, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France; and ¶Respiratory Medicine Department, Percy Military Hospital, Clamart, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bylicki
authors.forename: Damien
authors.initials: D
authors.lastname: Rouvière
authors.forename: Philippe
authors.initials: P
authors.lastname: Cassier
authors.forename: Lara
authors.initials: L
authors.lastname: Chalabreysse
authors.forename: Alice
authors.initials: A
authors.lastname: Levard
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Maury
authors.forename: Jacques
authors.initials: J
authors.lastname: Margery
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Blay
authors.forename: Julien
authors.initials: J
authors.lastname: Mazières
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010997:Pleural Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D012189:Retrospective Studies; D054363:Solitary Fibrous Tumor, Pleural / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome