Prediction of local and metastatic recurrence in solitary fibrous tumor: construction of a risk calculator in a multicenter cohort from the French Sarcoma Group (FSG) database

Salas, Sébastien; Resseguier, Noémie; Blay, Jean Yves; Cesne, Axel Le; Italiano, Antoîne; Chevreau, C.; Rosset, Philippe; Isambert, Nicolás; Soulié, P; Cupissol, Didier; Delcambre, Corinne; Bay, Jacques Olivier; Dubray‐Longeras, Pascale; Krengli, Marco; Bari, Berardino De; Villà, S.; Kaanders, Johannes H.A.M.; Torrente, S.; Pasquier, David; Thariat, Juliette; Myroslav, L.; Sole, C.V.; Dinçbaş, H. Fazilet Öner; Habboush, Jacob; Zilli, Thomas; Dragan, Tatiana; Khanfir, K.; Uğurluer, Gamze; Cena, Tiziana; Duffaud, Florence; Penel, Nicolas; Bertucci, François; Ranchère-Vince, Dominique; Terrier, P.; Bonvalot, Sylvie; Macagno, Nicolas; Lemoine, Caroline P.; Laé, Marick; Coindre, J.M.; Bouvier, Corinne

doi:10.1093/annonc/mdx250

Cited by 130 publications

(168 citation statements)

References 21 publications

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“…This may reflect the difficulty in validating multitiered models in small cohorts with low‐frequency events. We also found that radiation therapy was not a prognostic factor for LR, in agreement with the findings of one recent study, but contradicting others; instead, the main risk factors for LR in our series were margin status and mitoses. Selection bias may limit interpretation of this analysis, as radiation was used on larger tumours (median 100 mm versus 53 mm, P = 0.0002), and data on radiation therapy were available only for a relatively small number of patients in our cohort.…”

Section: Discussionsupporting

confidence: 86%

“…Moreover, necrosis (together with haemorrhage) is also considered to be a risk factor in pleural risk models of SFT . The Salas models utilise tumour site in their models of SFT behaviour, showing that extremity tumours were at increased risk for metastasis, and visceral tumours were at increased risk for LR . However, another series found intra‐abdominal and retroperitoneal tumours to be associated with worse disease‐specific survival than tumours in other sites, and no correlation between site and distant metastasis, similar to our own findings .…”

Section: Discussionsupporting

confidence: 84%

“…Thus, it best measures the risk of rapid recurrence, rather than late events, and, overall, lacks sufficient follow‐up data to be able to determine how well these models perform at predicting late recurrence. Likewise, the Salas and Pasquali series had median follow‐up times of 33 and 38 months, respectively . In contrast, the recent series comparing pleural SFT‐applicable risk models included patients with a median follow‐up of 5.5 years and a range up to 33 years; in this series with increased long‐term follow‐up, the mDemicco model still performed well in the prediction of disease recurrence …”

Section: Discussionmentioning

confidence: 94%

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Comparison of published risk models for prediction of outcome in patients with extrameningeal solitary fibrous tumour

et al. 2019

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Aims Solitary fibrous tumours (SFTs) are fibroblastic mesenchymal tumours with a 10–30% metastatic rate. Several risk models have been proposed for extrameningeal SFT, but they have not been evaluated in direct comparison with each other. The aim of this study is to compare the utility of published risk models in a multi‐institutional SFT cohort. Methods and results Clinicopathological data were evaluated for a cohort of extrameningeal SFTs, and used to stratify tumours by the use of five proposed risk models designed for soft tissue and/or pleural SFT [modified Demicco, Pasquali, Salas overall survival (OS), Salas metastasis, and Salas local recurrence (LR)]. Kaplan–Meier and Cox proportional hazards models were used to assess OS, time to first metastasis, time to first LR, and recurrence‐free survival (RFS). The study included 303 patients (109 from a referral cancer treatment centre; previously described in the original Demicco model) and an independent cohort from two large hospitals (n = 194). The median patient age was 54 years, and the median clinical follow‐up (available for 220 patients) was 37 months. The independent cohort had a 13% risk of metastasis at 5 years and a 16% risk of metastasis at 10 years. In this cohort, the modified Demicco, Salas OS, and Salas metastasis models predicted metastasis and RFS, whereas the Pasquali model had the best correlation with OS. Conclusions Multivariate risk models that include mitotic rate and patient age can more accurately predict aggressive behaviour in SFTs, with the modified Demicco and Salas OS risk models showing the best correlation with metastasis and RFS.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 94%

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Comparison of published risk models for prediction of outcome in patients with extrameningeal solitary fibrous tumour

et al. 2019

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“…We have proposed and validated a risk‐stratification model for SFT arising at all non‐meningeal sites based on a combination of tumour size, mitotic count, tumour necrosis and patient age . Other published risk prediction models include both site‐specific and more generally applicable models . However, none of these models address the underlying biology driving aggressive behaviour.…”

Section: Introductionmentioning

confidence: 99%

TERT promoter mutations in solitary fibrous tumour

et al. 2018

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“…Solitary fibrous tumor (SFT) is a mesenchymal tumor with uncertain differentiation and intermediate malignant potential . SFTs can arise at any location (pleural or extrapleural) and display a wide histopathological spectrum, frequently with hemangiopericytoma‐like vessels . Several other histological patterns have also been described, including round cell, giant‐cell‐containing, epithelioid, myxoid, fat‐forming, pleomorphic and dedifferentiated variants .…”

Section: Introductionmentioning

confidence: 99%

Controversial issues in soft tissue solitary fibrous tumors: A pathological and molecular review

Machado

Nieto‐Morales

Cruz

et al. 2020

Pathology International

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The clinical evolution of solitary fibrous tumor (SFT) remains unclear. Although various clinical, morphological and molecular criteria may indicate increased risk of malignancy, some SFT can still progress despite having a clearly benign appearance. Various risk stratification systems have been proposed, but unfortunately they are not sufficient to precisely determine the malignant potential. In this review, we discuss current knowledge on SFT, focusing on the following controversial issues: (i) the diverse morphologic spectrum: ‘the great simulator;’ (ii) malignant transformation or dedifferentiation; (iii) current risk stratification systems; and (iv) molecular factors associated with clinical evolution. The morphological spectrum of SFT and the list of differential diagnoses continue to expand. Both have increased considerably since the first descriptions of specific molecular alterations. A classification of malignant SFT should not be based on histology alone. The correlation of all pathological and molecular factors is recommended; its inclusion in risk stratification systems may help to improve diagnosis and prognosis.

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Prediction of local and metastatic recurrence in solitary fibrous tumor: construction of a risk calculator in a multicenter cohort from the French Sarcoma Group (FSG) database

Cited by 130 publications

References 21 publications

Comparison of published risk models for prediction of outcome in patients with extrameningeal solitary fibrous tumour

Comparison of published risk models for prediction of outcome in patients with extrameningeal solitary fibrous tumour

TERT promoter mutations in solitary fibrous tumour

Controversial issues in soft tissue solitary fibrous tumors: A pathological and molecular review

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