title: Resectable extra-pleural and extra-meningeal solitary fibrous tumours: A multi-centre prognostic study.
abstract: Extra-pleural and extra-meningeal solitary fibrous tumour (SFT) is a rare sarcoma histotype curable with surgery in the majority of patients. The behaviour of these tumours ranges from indolent/very low grade to malignant/high grade but it is still not possible to accurately predict prognosis after surgery. We have investigated a multi-centre series to stratify the risk of recurrence to patients with SFTs.
  
  
  
  We retrospectively analysed the data from 243 patients who underwent surgery (2002-2011) at four sarcoma referral centres.
  
  
  
  Upon univariate analysis, hypercellularity, atypia, necrosis, high mitotic rate (ie >4 mitoses/10 HPF) were associated with both disease-free and overall survival. Surgical margins were a significant prognostic factor for disease-free (P = 0.007) but not for overall survival. Unexpectedly, larger tumour size was associated with a better prognosis (P = 0.038) and fewer recurrences (P = 0.024). Upon multivariable analysis, high mitotic rate (hazard ratio, HR = 2.85, P = 0.002), cellular atypia (HR = 1.62, P = 0.015) and hypercellularity (HR = 1.82, P = 0.031) were significantly associated with recurrences. A SFT recurrence score has been provided to stratify risk of recurrence.
  
  
  
  This study provides a prognostic model to stratify risk of recurrence in patients with resectable SFTs. This allows clinician to decide on an optimal follow-up strategy and to select patients that may benefit from adjuvant treatments.
authors.affiliation: Midlands Abdominal and Retroperitoneal Sarcoma Unit (MARSU), Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: S
authors.initials: S
authors.lastname: Pasquali
authors.affiliation: Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian, Milan 20133, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gronchi
authors.affiliation: Sarcoma Unit, Department of Surgery, Royal Marsden NHS Foundation Trust, Fulham Rd, London SW3 6JJ, UK.
authors.forename: D
authors.initials: D
authors.lastname: Strauss
authors.affiliation: Department of Surgical Oncology, Institut Gustave Roussy, Rue Edouard Vaillant, 94800 Villejuif, France.
authors.forename: S
authors.initials: S
authors.lastname: Bonvalot
authors.affiliation: Department of Surgery, Royal Orthopedic Hospital, Bristol Rd S, Birmingham B31 2AP, UK.
authors.forename: L
authors.initials: L
authors.lastname: Jeys
authors.affiliation: Cancer Medicine Department, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian, Milan 20133, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Stacchiotti
authors.affiliation: Sarcoma Unit, Department of Surgery, Royal Marsden NHS Foundation Trust, Fulham Rd, London SW3 6JJ, UK.
authors.forename: A
authors.initials: A
authors.lastname: Hayes
authors.affiliation: Department of Surgical Oncology, Institut Gustave Roussy, Rue Edouard Vaillant, 94800 Villejuif, France.
authors.forename: C
authors.initials: C
authors.lastname: Honore
authors.affiliation: Department of Diagnostic Pathology and Laboratory Medicine, IRCCS Istituto Nazionale dei Tumori, via Venezian, Milan 20133, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Collini
authors.affiliation: Department of Diagnostic Pathology and Laboratory Medicine, IRCCS Istituto Nazionale dei Tumori, via Venezian, Milan 20133, Italy.
authors.forename: S L
authors.initials: SL
authors.lastname: Renne
authors.affiliation: Sarcoma Unit, Department of Surgery, Royal Marsden NHS Foundation Trust, Fulham Rd, London SW3 6JJ, UK.
authors.forename: N
authors.initials: N
authors.lastname: Alexander
authors.affiliation: Department of Surgery, Royal Orthopedic Hospital, Bristol Rd S, Birmingham B31 2AP, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Grimer
authors.affiliation: Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian, Milan 20133, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Callegaro
authors.affiliation: Department of Musculoskeletal Pathology, Royal Orthopaedic Hospital, Bristol Rd S, Birmingham B31 2AP, UK.
authors.forename: V P
authors.initials: VP
authors.lastname: Sumathi
authors.affiliation: Midlands Abdominal and Retroperitoneal Sarcoma Unit (MARSU), Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK.
authors.forename: D
authors.initials: D
authors.lastname: Gourevitch
authors.affiliation: Midlands Abdominal and Retroperitoneal Sarcoma Unit (MARSU), Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK. Electronic address: anant.desai@uhb.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Desai
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D008940:Mitotic Index; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D054364:Solitary Fibrous Tumors / Q000473:pathology* / Q000601:surgery*
keywords: Haemangiopericytoma; Prognosis; Sarcoma; Solitary fibrous tumour