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Objectives <p>Solitary fibrous tumour of the pleura (SFTP) is a rare mesenchymal neoplasm with an excellent prognosis after surgery. However, a small subset exhibits aggressive behaviour, developing metastases and recurrences even more than 10 years after treatment. Several classifications based on clinical and histological features attempt to predict the risk of recurrence and metastasis. The aim of this study is to describe our experience in the management of these tumours, review the existing literature, and assess whether the different prognostic classifications are applicable to our series.</p> Methods <p>We conducted a retrospective observational study of 48 patients who underwent surgery for SFTP between January 2006 and July 2025. The following variables were recorded: clinical presentation, imaging characteristics, surgical approach, histopathology, immunohistochemistry, long-term outcomes, and recurrence-free and overall survival were analysed. The prognostic classifications used were those of England, de&#xa0;Perrot, Demicco, Tapias, and Diebold.</p> Results <p>VATS was the predominant surgical approach. 36 cases (75%) were histologically benign, while 12 cases (25%) met criteria for malignancy. Only one patient (2.1%) developed tumour recurrence, occurring 8 years after surgery. None of the prognostic classifications were useful in predicting recurrence. The single recurrent case was classified as histologically benign and low-risk by all classifications except Demicco, which designated it as intermediate risk.</p> Conclusions <p>In our series, the existing prognostic classifications did not reliably predict recurrence, supporting the recommendation for long-term follow-up regardless of histological features. While standardized clinical-pathological criteria remain the current cornerstone of management, the future integration of routine molecular markers across pathology laboratories may help refine these risk stratification protocols.</p>

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Solitary fibrous tumour of the pleura: evolution in surgical management and challenges in prognostic evaluation

  • 期刊论文

  • 发表日期：

    2026年7月22日

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  • Laura Sacristán,
  • Montserrat Blanco,
  • Helen Simón,
  • Milagros Moldes,
  • Rommel Carrasco,
  • Miguel Angel Cañizares,
  • Jesús Albort,
  • Eva García-Fontán

摘要

Objectives

Solitary fibrous tumour of the pleura (SFTP) is a rare mesenchymal neoplasm with an excellent prognosis after surgery. However, a small subset exhibits aggressive behaviour, developing metastases and recurrences even more than 10 years after treatment. Several classifications based on clinical and histological features attempt to predict the risk of recurrence and metastasis. The aim of this study is to describe our experience in the management of these tumours, review the existing literature, and assess whether the different prognostic classifications are applicable to our series.

Methods

We conducted a retrospective observational study of 48 patients who underwent surgery for SFTP between January 2006 and July 2025. The following variables were recorded: clinical presentation, imaging characteristics, surgical approach, histopathology, immunohistochemistry, long-term outcomes, and recurrence-free and overall survival were analysed. The prognostic classifications used were those of England, de Perrot, Demicco, Tapias, and Diebold.

Results

VATS was the predominant surgical approach. 36 cases (75%) were histologically benign, while 12 cases (25%) met criteria for malignancy. Only one patient (2.1%) developed tumour recurrence, occurring 8 years after surgery. None of the prognostic classifications were useful in predicting recurrence. The single recurrent case was classified as histologically benign and low-risk by all classifications except Demicco, which designated it as intermediate risk.

Conclusions

In our series, the existing prognostic classifications did not reliably predict recurrence, supporting the recommendation for long-term follow-up regardless of histological features. While standardized clinical-pathological criteria remain the current cornerstone of management, the future integration of routine molecular markers across pathology laboratories may help refine these risk stratification protocols.