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Prognostic value of MIB-1 proliferation index in solitary fibrous tumors of the pleura implemented in a new score - a multicenter study.

ABSTRACT: BACKGROUND:Although the majority of solitary fibrous tumors of the pleura (SFTP) follow a benign course, 10-25% of patients suffer from recurrence or metastatic disease. Several scoring models have been proposed to predict the outcome. However, none of these included immunohistochemical (IHC) markers as possible prognosticators. METHODS:In this multicenter study, we collected clinical data and formalin-fixed and paraffin-embedded (FFPE) tissue blocks of patients with histologically proven SFTP which had been surgically resected between 2000 und 2015. After systematic and extensive IHC staining on tissue microarrays, the results were analyzed and compared to histomorphological and clinical data for their possible prognostic value. RESULTS:In total, 78 patients (mean age 61?±?11 years) were included. Of these, 9 patients (11%) had an adverse outcome including SFTP recurrence (n?=?6) or SFTP-related death (n?=?3). Mean overall survival was 172?±?13 months. 1 and 10-year event-free survival rates were 99% and 93%. In the multivariable analysis only MIB-1 proliferation index (Ki-67) ?10% (HR 12.3, CI 1.1-139.5, p?=?0.043), ?4 mitoses per 10 high power fields (HR 36.5, CI 1.2-1103.7, p?=?0.039) and tumor size larger than 10 cm (HR 81.8, CI 1.7-4016.8, p?=?0.027) were independently associated with adverse outcome. CONCLUSION:A high proliferation rate by MIB-1 IHC was associated with impaired outcome. Upon this, we established a new score using mitosis, necrosis, size of the tumor and MIB-1, which performed better than the traditional scores in our data set. This prognostic score could help to better evaluate outcome of SFTP, but requires external validation.

SUBMITTER: Diebold M

PROVIDER: S-EPMC5732426 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Prognostic value of MIB-1 proliferation index in solitary fibrous tumors of the pleura implemented in a new score - a multicenter study.

Diebold Matthias M Soltermann Alex A Hottinger Selma S Haile Sarah R SR Bubendorf Lukas L Komminoth Paul P Jochum Wolfram W Grobholz Rainer R Theegarten Dirk D Berezowska Sabina S Darwiche Kaid K Oezkan Filiz F Kohler Malcolm M Franzen Daniel P DP

Respiratory research 20171216 1

<h4>Background</h4>Although the majority of solitary fibrous tumors of the pleura (SFTP) follow a benign course, 10-25% of patients suffer from recurrence or metastatic disease. Several scoring models have been proposed to predict the outcome. However, none of these included immunohistochemical (IHC) markers as possible prognosticators.<h4>Methods</h4>In this multicenter study, we collected clinical data and formalin-fixed and paraffin-embedded (FFPE) tissue blocks of patients with histologicall ...[more]

PMID: 29246159

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Project description:Simple Summary Solitary fibrous tumors are rare benign or cancerous tumors that develop in all tissues, including close to the spinal cord. These cases are exceptional and we describe their presentation and outcome based on 31 published cases and 10 patients on whom we operated. The tumors can develop in any portion of the spine and cause back pain, associated with neurological deficits, such as compression of a nerve or the spinal cord, in 66% of patients. Surgical removal is the first step towards diagnosis and treatment, but complete removal could be achieved in only 70% of patients, due to bleeding or spinal cord invasion. Tumors were found to recur after a mean 5.8 years (1 to 25), without identified risk factors. However, in patients with subtotal removal, radiotherapy significantly improves the rate of recurrence. In total, spinal solitary fibrous tumors are treated by neurosurgeons on the front line but discussion in a multidisciplinary team will provide general treatments, especially radiotherapy after subtotal removal. Abstract All solitary fibrous tumors (SFT), now histologically diagnosed by a positive nuclear STAT6 immunostaining, represent less than 2% of soft tissue sarcomas, with spinal SFT constituting a maximum of 2% of them, making these tumors extremely rare. We provide an up-to-date overview of their diagnosis, treatment, and prognosis. We included 10 primary STAT6-positive SFT from our retrospective cohort and 31 from a systematic review. Spinal pain was the most common symptom, in 69% of patients, and the only one in 34%, followed by spinal cord compression in 41%, radicular compression, including pain or deficit, in 36%, and urinary dysfunction specifically in 18%. Preoperative diagnosis was never obtained. Gross total resection was achieved in 71%, in the absence of spinal cord invasion or excessive bleeding. Histologically, they were 35% grade I, 25% grade II, and 40% grade III. Recurrence was observed in 43% after a mean 5.8 years (1 to 25). No significant risk factor was identified, but adjuvant radiotherapy improved the recurrence-free survival after subtotal resection. In conclusion, spinal SFT must be treated by neurosurgeons as part of a multidisciplinary team. Owing to their close relationship with the spinal cord, radiotherapy should be considered when gross total resection cannot be achieved, to lower the risk of recurrence.

Dataset Information

Prognostic value of MIB-1 proliferation index in solitary fibrous tumors of the pleura implemented in a new score - a multicenter study.

Publications

Prognostic value of MIB-1 proliferation index in solitary fibrous tumors of the pleura implemented in a new score - a multicenter study.

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