Management of solitary fibrous tumours of the pleura: a systematic review and meta-analysis.

Autor:	Mercer RM; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK.; Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK., Wigston C; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK., Banka R; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK., Cardillo G; San Camillo Forlanini Hospital, Rome, Italy., Benamore R; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK., Nicholson AG; Dept of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, and National Heart and Lung Institute, Imperial College, London, UK., Asciak R; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK.; Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK., Hassan M; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK.; Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK.; Chest Diseases Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt., Hallifax RJ; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK.; Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK., Wing L; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK., Bedawi EO; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK.; Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK., Maskell NA; Academic Respiratory Unit, Bristol Medical School, Southmead Hospital, University of Bristol, Bristol, UK., Harriss EK; Bodleian Health Care Libraries, University of Oxford, Oxford, UK., Miller RF; Institute for Global Health, University College London, London, UK., Rahman NM; University of Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK.; Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK.; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
Jazyk:	angličtina
Zdroj:	ERJ open research [ERJ Open Res] 2020 Aug 17; Vol. 6 (3). Date of Electronic Publication: 2020 Aug 17 (Print Publication: 2020).
DOI:	10.1183/23120541.00055-2020
Abstrakt:	Background: Solitary fibrous tumours of the pleura (SFTP), or pleural fibromas, are rare tumours that generally, but not universally, follow a benign course. Surgical resection is the standard treatment, but there are no evidence-based guidelines regarding the management of these tumours. Methods: Five databases were searched from inception to April 1, 2019 for studies reporting on SFTP management. Results: Twenty-seven studies met the inclusion criteria (1542 patients, all non-comparative case series); 98% of these patients underwent resection and all SFTP included were pathologically diagnosed. 394 out of 1299 cases (30.5%, 95% CI 27.8-32.8%) were malignant with recurrence rates of between 0% and 42.9%. A pleural effusion was always associated with a negative outcome, but no other features were consistently reported to have negative associations. Preoperative biopsies incorrectly reported malignant histology in two studies. Over 25% of cases of recurrence occurred when a complete (R0) resection had been achieved. The first recurrence occurred >5 years after the initial resection in at least 23% of cases. Conclusions: There is strong evidence to support long-term surveillance after surgical resection of SFTP, even where a complete (R0) resection has been achieved; however, there is no clear evidence to inform clinicians regarding the selection of patients who should undergo resection. The rates of malignant SFTP and SFTP recurrence are higher than previously reported. Only those that were pathologically diagnosed or resected were included, which may bias the data towards more aggressive tumours. Data collection on radiologically diagnosed SFTP is required to draw conclusions regarding the timing and need for intervention. Competing Interests: Conflict of interest: R.M. Mercer has nothing to disclose. Conflict of interest: C. Wigston has nothing to disclose. Conflict of interest: R. Banka has nothing to disclose. Conflict of interest: G. Cardillo has nothing to disclose. Conflict of interest: R. Benamore has nothing to disclose. Conflict of interest: G. Cardillo has nothing to disclose. Conflict of interest: R. Asciak has nothing to disclose. Conflict of interest: M. Hassan has nothing to disclose. Conflict of interest: R.J. Hallifax has nothing to disclose. Conflict of interest: L. Wing has nothing to disclose. Conflict of interest: E.O. Bedawi has nothing to disclose. Conflict of interest: N.A. Maskell reports an unrestricted research grant from Rocket and Becton Dickinson for IPC plus HiSPEC and REDUCE studies, and sat on the advisory board for cook medical. Conflict of interest: E. Harriss has nothing to disclose. Conflict of interest: R.F. Miller reports personal fees for a nonpromotional lecture on clinical aspects of HIV infection from Gilead outside the submitted work. Conflict of interest: N.J. Rahman reports grants and personal fees from Rocket Medical UK, grants from BD USA, and personal fees from Lung therapeutics USA, outside the submitted work. (Copyright ©ERS 2020.)
Databáze:	MEDLINE
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