Clinical Outcomes of Surgical Management of Solitary Fibrous Tumors of the Pleura Landreneau JR, Schuchert MJ, Eckard CS, Odell DD, Wizorek JJ, McCormick KN, Ferson PF, Yousem S, Dacic S, Luketich JD, Landreneau RJ

Background and Objective ● Malignant solitary fibrous tumors of the pleura are rare mesenchymal neoplasms that are associated with a high rate of recurrence and often require the need for reoperation. ● We evaluated the outcomes of patients with malignant solitary fibrous tumors of the pleura to review contemporary management strategies, and to measure the impact of tumor size on the respective patient’s risk of recurrence and survival.

Methods ● Retrospective review of 46 patients with solitary fibrous tumors of the pleura from ● Primary endpoints of the study included surgical management strategy, size of the original tumor, overall length of stay, complications, and mortality. ● Survival curves were calculated utilizing the Kaplan-Maier method. ● Resections performed included wide local excision (n=4), wedge resection (n=2), segmentectomy (n=2), lobectomy (n=3), and pneumonectomy (n=1).

Results ● 12/46 patients (26.1%) had malignant histology 5 Year Survival = 54% Survival (%) Time (months) ● Median age was 62.5 (Range:46-74) ● Gender ratio was 9F:3M ● Seven patients had recurrence (58.3%) ● Average number of re-operations was 1.9 ● Recurrence was associated with diminished overall survival compared to patients without recurrence (36 vs. 100%). Overall Survival ● Patients with recurrence had a significantly larger average tumor size than patients without recurrence (20.0 cm. vs. 7.1 cm, p=0.006)

Conclusions ● Benign histology is associated with a low likelihood of recurrence ● Larger tumors with histological signs of malignancy require closer follow-up secondary to troubling and frequent local recurrence rates and potential associated mortality