Annals of Surgical Oncology

, Volume 20, Issue 13, pp 4090–4095 | Cite as

Prognosis of Solitary Fibrous Tumors: A Multicenter Study

  • Winan J. van Houdt
  • Charlotte M. A. Westerveld
  • Joyce E. P. Vrijenhoek
  • Joost van Gorp
  • Frits van Coevorden
  • Cornelis Verhoef
  • Thijs van Dalen
Bone and Soft Tissue Sarcomas



Solitary fibrous tumors (SFTs) are rare mesenchymal tumors, and data regarding outcome and prognostic factors are scarce. We report the outcome and analysis of prognostic factors of a retrospective multicenter cohort study for patients treated for SFTs.


Retrospective analysis was performed of patients treated for SFTs between 1995 and 2012. Clinical and histopathological features were analyzed for prognostic value. Endpoints were set at local recurrence, metastasis formation, or death. Survival was analyzed using Kaplan–Meier and Cox proportional hazards analyses.


A total of 81 patients underwent surgical resection of a SFT with curative intent. During follow-up, 21 patients developed distant metastases, while 18 patients developed local recurrence. The 5-year overall survival was 84 %. The local recurrence rate and the metastasis rate at 5 years were 29 and 34 %, respectively. Of all factors analyzed, positive resection margin significantly correlated with local recurrence [hazard ratio (HR) 4.8; 95 % confidence interval (95 % CI) 1.5–14.9]. Tumor size >10 cm (HR 4.4; 95 % CI 1.7–11.5) and high mitosis rate (HR 3.3; 95 % CI 1.06–10.3) significantly correlated with higher incidence of metastases. The combination of tumors >10 cm and high mitosis rate significantly correlated with higher incidence of metastases (HR 4.8; 95 % CI 1.4–16.2) and showed a trend toward worse overall survival (HR 5.7; 95 % CI 0.95–34.7).


A substantial portion of patients with a SFT developed local recurrence or metastases. Local recurrence is significantly higher in patients with positive resection margins; metastasis frequency is significantly higher in patients with tumors >10 cm and tumors with a high mitosis rate.


Local Recurrence Smooth Muscle Actin Epithelial Membrane Antigen Solitary Fibrous Tumor Metastasis Formation 
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  1. 1.
    Klemperer P, Coleman BR. Primary neoplasms of the pleura. A report of five cases. Am J Ind Med. 1992;22:1–31.PubMedCrossRefGoogle Scholar
  2. 2.
    de Perrot M, Fischer S, Brundler MA, Sekine Y, Keshavjee S. Solitary fibrous tumors of the pleura. Ann Thorac Surg. 2002;74:285–93.PubMedCrossRefGoogle Scholar
  3. 3.
    Guo W, Xiao HL, Jiang YG, Wang RW, Zhao YP, Ma Z, et al. Retrospective analysis for thirty-nine patients with solitary fibrous tumor of pleura and review of the literature. World J Surg Oncol. 2011;9:134.PubMedCrossRefGoogle Scholar
  4. 4.
    Magdeleinat P, Alifano M, Petino A, Le Rochais JP, Dulmet E, Galateau F, et al. Solitary fibrous tumors of the pleura: clinical characteristics, surgical treatment and outcome. Eur J Cardiothorac Surg. 2002;21:1087–93.PubMedCrossRefGoogle Scholar
  5. 5.
    Brunnemann RB, Ro JY, Ordonez NG, Mooney J, El-Naggar AK, Ayala AG. Extrapleural solitary fibrous tumor: a clinicopathologic study of 24 cases. Mod Pathol. 1999;12:1034–42.PubMedGoogle Scholar
  6. 6.
    Chen H, Zeng XW, Wu JS, Dou YF, Wang Y, Zhong P, et al. Solitary fibrous tumor of the central nervous system: a clinicopathologic study of 24 cases. Acta Neurochir (Wien). 2012;154:237–48.CrossRefGoogle Scholar
  7. 7.
    Chen H, Xiao CW, Wang T, Wu JS, Jiang CC, Qian J, et al. Orbital solitary fibrous tumor: a clinicopathologic study of ten cases with long-term follow-up. Acta Neurochir (Wien). 2012;154:249–55.CrossRefGoogle Scholar
  8. 8.
    Daigeler A, Lehnhardt M, Langer S, Steinstraesser L, Steinau HU, Mentzel T, et al. Clinicopathological findings in a case series of extrathoracic solitary fibrous tumors of soft tissues. BMC Surg. 2006;6:10.PubMedCrossRefGoogle Scholar
  9. 9.
    Erdag G, Qureshi HS, Patterson JW, Wick MR. Solitary fibrous tumors of the skin: a clinicopathologic study of 10 cases and review of the literature. J Cutan Pathol. 2007;34:844–50.PubMedCrossRefGoogle Scholar
  10. 10.
    Hasegawa T, Matsuno Y, Shimoda T, Hasegawa F, Sano T, Hirohashi S. Extrathoracic solitary fibrous tumors: their histological variability and potentially aggressive behavior. Hum Pathol. 1999;30:1464–73.PubMedCrossRefGoogle Scholar
  11. 11.
    Witkin GB, Rosai J. Solitary fibrous tumor of the upper respiratory tract. A report of six cases. Am J Surg Pathol. 1991;15:842–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Fukunaga M, Naganuma H, Nikaido T, Harada T, Ushigome S. Extrapleural solitary fibrous tumor: a report of seven cases. Mod Pathol. 1997;10:443–50.PubMedGoogle Scholar
  13. 13.
    Musyoki FN, Nahal A, Powell TI. Solitary fibrous tumor: an update on the spectrum of extrapleural manifestations. Skeletal Radiol. 2012;41:5–13.PubMedCrossRefGoogle Scholar
  14. 14.
    Gold JS, Antonescu CR, Hajdu C, Ferrone CR, Hussain M, Lewis JJ, et al. Clinicopathologic correlates of solitary fibrous tumors. Cancer. 2002;94:1057–68.PubMedCrossRefGoogle Scholar
  15. 15.
    Hanau CA, Miettinen M. Solitary fibrous tumor: histological and immunohistochemical spectrum of benign and malignant variants presenting at different sites. Hum Pathol. 1995;26:440–9.PubMedCrossRefGoogle Scholar
  16. 16.
    England DM, Hochholzer L, McCarthy MJ. Localized benign and malignant fibrous tumors of the pleura. A clinicopathologic review of 223 cases. Am J Surg Pathol. 1989;13:640–58.PubMedCrossRefGoogle Scholar
  17. 17.
    Rao N, Colby TV, Falconieri G, Cohen H, Moran CA, Suster S. Intrapulmonary solitary fibrous tumors: clinicopathologic and immunohistochemical study of 24 cases. Am J Surg Pathol. 2013;37:155–66.PubMedCrossRefGoogle Scholar
  18. 18.
    Vallat-Decouvelaere AV, Dry SM, Fletcher CD. Atypical and malignant solitary fibrous tumors in extrathoracic locations: evidence of their comparability to intra-thoracic tumors. Am J Surg Pathol. 1998;22:1501–11.PubMedCrossRefGoogle Scholar
  19. 19.
    Insabato L, Siano M, Somma A, Gentile R, Santangelo M, Pettinato G. Extrapleural solitary fibrous tumor: a clinicopathologic study of 19 cases. Int J Surg Pathol. 2009;17:250–4.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Winan J. van Houdt
    • 1
    • 2
  • Charlotte M. A. Westerveld
    • 1
  • Joyce E. P. Vrijenhoek
    • 2
  • Joost van Gorp
    • 3
  • Frits van Coevorden
    • 4
  • Cornelis Verhoef
    • 5
  • Thijs van Dalen
    • 1
  1. 1.Department of SurgeryDiakonessenhuis Hospital UtrechtUtrechtThe Netherlands
  2. 2.Department of SurgeryUniversity Medical Center Utrecht (UMC)UtrechtThe Netherlands
  3. 3.Department of PathologyDiakonessenhuis Hospital UtrechtUtrechtThe Netherlands
  4. 4.Department of Surgical OncologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  5. 5.Department of SurgeryErasmusMC-Daniel den Hoed Cancer CenterRotterdamThe Netherlands

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