title: Retroperitoneal solitary fibrous tumor: surgery as first line therapy.
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.
  
  
  CONCLUSIONS
  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.
authors: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226 USA.
authors: Rahul
authors: R
authors: Rajeev
authors: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226 USA.
authors: Mohit
authors: M
authors: Patel
authors: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226 USA.
authors: Thejus T
authors: TT
authors: Jayakrishnan
authors: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226 USA.
authors: Fabian M
authors: FM
authors: Johnston
authors: Department of Radiation Oncology, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226 USA.
authors: Meena
authors: M
authors: Bedi
authors: Section of Hematology and Oncology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226 USA.
authors: John
authors: J
authors: Charlson
authors: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226 USA.
authors: Kiran K
authors: KK
authors: Turaga
keywords: Adjuvant chemotherapy; Adjuvant radiotherapy; Retroperitoneal sarcoma; Solitary fibrous tumors; Surgical Oncology; Surgical outcomes