Metastatic Patterns of Solitary Fibrous Tumors: A Single-Institution Experience
| Autor: | Jason L. Hornick, Nikhil H. Ramaiya, Atul B. Shinagare, Woo S. Do, Ailbhe C. O’Neill, Sree Harsha Tirumani, Abhishek R. Keraliya |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Solitary fibrous tumor medicine.medical_specialty 03 medical and health sciences 0302 clinical medicine Risk Factors Interquartile range Prevalence medicine Humans Radiology Nuclear Medicine and imaging Single institution Neoplasm Staging Univariate analysis Tumor size Proportional hazards model business.industry Medical record Retrospective cohort study General Medicine Middle Aged Thoracic Neoplasms medicine.disease Magnetic Resonance Imaging Survival Rate Solitary Fibrous Tumors 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Radiology Tomography X-Ray Computed business Boston |
| Zdroj: | American Journal of Roentgenology. 208:2-9 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.16.16662 |
| Popis: | The objective of our study was to evaluate the metastatic patterns and imaging features of solitary fibrous tumors (SFTs).This retrospective study included 139 patients with pathologically proven SFT, 49 of whom developed metastases. Electronic medical records and all available images were reviewed to record the pattern and imaging appearances of metastatic disease, and comparisons of thoracic SFTs and extrathoracic SFTs were also performed. Associations of metastatic spread were studied using univariate and multivariate Cox regression analyses.A total of 49 (35%) patients developed metastases at a median of 124 months (interquartile range [IQR], 66-195 months) after SFT diagnosis; 11 patients (8%) had metastases at presentation. Of these 49 patients, 40 patients died at a mean of 183 months after diagnosis. The associations with metastatic disease on univariate analysis were tumor size ≥ 10 cm (p = 0.01) and malignant pathology or mitotic count ≥ 4 per 10 high-power fields (HPF) (p0.001). Malignant pathology and a mitotic count of ≥ 4 per 10 HPF were also associated with metastatic disease on multivariate analysis (p = 0.01; hazard ratio, 0.22; 95% CI, 0.05-0.73). The most common sites of metastasis were the lungs (30/49, 61%) followed by the pleura (24/49, 49%) and then the liver (20/49, 41%), bones (20/49, 41%), and peritoneum (20/49, 41%). A significantly higher proportion of patients with extrathoracic SFT had metastatic disease (37/139, 27%) compared with those with thoracic SFT (12/139, 9%) (p = 0.003). The overall metastasis-free survival was a median of 117 months (IQR, 33-169 months) in patients with extrathoracic SFT and a median of 120 months (IQR, 82-169 months) in patients with thoracic SFT (p = 0.01).A mitotic count of ≥ 4 per 10 HPF or malignant pathology was significantly associated with metastatic disease on both univariate and multivariate analyses. The sites of metastatic disease differed depending on the site of the primary SFT but were most commonly the lung and pleura. Patients with extrathoracic SFT were statistically more likely to develop metastatic disease than those with thoracic SFT. |
| Databáze: | OpenAIRE |
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