ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026
Solitary fibrous tumour of the pleura: evolution in surgical management and challenges in prognostic evaluation.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesSolitary 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.
methodsWe 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.
resultsVATS 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.
conclusionsIn 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.
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