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Original Research: Lung Cancer |

Validation of a Scoring System to Predict Recurrence of Resected Solitary Fibrous Tumors of the PleuraRecurrence Score for Solitary Fibrous Tumors

Luis F. Tapias, MD; Olaf Mercier, MD, PhD; Maria R. Ghigna, MD; Benoit Lahon, MD; Hang Lee, PhD; Douglas J. Mathisen, MD, FCCP; Philippe Dartevelle, MD; Michael Lanuti, MD, FCCP
Author and Funding Information

From the Division of Thoracic Surgery (Drs Tapias, Mathisen, and Lanuti), and the Biostatistics Center (Dr Lee), Massachusetts General Hospital, Boston, MA; and the Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation (Drs Mercier, Ghigna, Lahon, and Dartevelle), Marie Lannelongue Hospital, Paris, France.

CORRESPONDENCE TO: Michael Lanuti, MD, FCCP, Division of Thoracic Surgery, Massachusetts General Hospital, 55 Fruit St, Blake 1570, Boston, MA 02114; e-mail: mlanuti@mgh.harvard.edu


FUNDING/SUPPORT: The statistical analysis of this work was conducted with support from Harvard Catalyst: The Harvard Clinical and Translational Science Center, National Center for Research Resources, and the National Center for Advancing Translational Sciences, National Institutes of Health [Award 8UL1TR000170-05], and financial contributions from Harvard University and its affiliated academic health-care centers.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(1):216-223. doi:10.1378/chest.14-1180
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BACKGROUND:  Solitary fibrous tumors of the pleura (SFTPs) are infrequent neoplasms with no standardized criteria to predict risk of recurrence after curative surgery. The aim of the present study is to validate a recently proposed recurrence score in a large European cohort of patients with SFTP.

METHODS:  Validation of a previously published scoring system was assessed in a population of 113 patients who underwent complete resection of SFTPs. Patients were scored according to the pleural origin, morphology, size, hypercellularity, presence of necrosis or hemorrhage, and number of mitoses in their SFTPs. Receiver operating characteristic curves were plotted for the score. Time to recurrence analysis was performed using the Kaplan-Meier and Cox proportional hazards methods.

RESULTS:  After a mean follow-up of 13.2 ± 7.3 years, there were nine recurrences (8.0%). Score performance to predict recurrence was as follows: sensitivity = 78%, specificity = 74%, positive likelihood ratio = 3.0, and negative likelihood ratio = 0.3. A cutoff of 3 points was used to classify 79 patients (69.9%) at low risk and 34 patients (30.1%) at high risk for recurrence. A high-risk classification was significantly associated with more recurrences during follow-up (P = .004), worse overall survival (P = .0008), more extensive lung resections (P = .001), and the use of adjuvant therapies (P = .009). The present score outperformed England’s criteria (P = .049) and de Perrot classification (P < .001) when predicting SFTP recurrence.

CONCLUSIONS:  The proposed scoring system, which combines common clinical and histologic features of resected SFTPs, remains predictive of recurrence in a separate patient population. The simple score may guide the postoperative surveillance of this uncommon tumor.

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