Abstract
Solitary fibrous tumor (SFT) is a soft-tissue neoplasm of intermediate malignant potential, presenting a wide histopathological spectrum. Poorer prognosis of hemangiopericytoma of the central nervous system (CNS), hypoglycemic SFT, and dedifferentiation are well-known characters of SFT, but their clinical significance were not demonstrated enough by large-sized study. Here, the clinicopathological features of SFTs are reviewed and the relationship between genetics and clinicopathological features is examined using 145 SFT cases. All cases were STAT6 IHC-positive and/or NAB2-STAT6 fusion gene-positive. Tumor location was classified into three categories: 30 pleuropulmonary, 96 non-pleuropulmonary/non-central nervous system (CNS), and 18 CNS tumors. The tumor developed recurrence in 21 of 93 available cases (22.5%), metastasis in 11 of 93 (11.8%), and tumor death in 9 of 93 (9.6%). Hypoglycemia occurred in 2 primary tumors and 1 metastatic tumor among 63 reviewable cases, and dedifferentiation occurred in 10 cases (6.8%) including 6 primary tumors, 2 recurrent tumors, and 2 metastatic tumors. Recurrence was positively associated with CNS location (p = 0.0109) and hypoglycemia (p = 0.001); metastasis was positively associated with CNS location (p = 0.0231), hypoglycemia (p < 0.0001), and dedifferentiation (p < 0.0001), while metastasis was negatively correlated with pleural location (p = 0.0471). Tumor death was positively associated with male sex (p = 0.0154), larger size (p = 0.0455), hypoglycemia (p < 0.0001), and dedifferentiation (p < 0.0001). Multivariate analysis revealed independent statistical significance of dedifferentiation for overall survival (p = 0.0467). Exon variant of the fusion gene had no statistical correlation with clinical outcome. In conclusion, dedifferentiation is a major prognostic factor of SFT, and specific location such as cerebromeningeal and intra-abdominal site and hypoglycemia also had a high risk for unfavorable prognosis.
| Original language | English |
|---|---|
| Pages (from-to) | 467-477 |
| Number of pages | 11 |
| Journal | Virchows Archiv |
| Volume | 475 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Oct 1 2019 |
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All Science Journal Classification (ASJC) codes
- Pathology and Forensic Medicine
- Molecular Biology
- Cell Biology
Cite this
Clinicopathological review of solitary fibrous tumors : dedifferentiation is a major cause of patient death. / Yamada, Yuichi; Kohashi, Kenichi; Kinoshita, Izumi; Yamamoto, Hidetaka; Iwasaki, Takeshi; Yoshimoto, Masato; Ishihara, Shin; Toda, Yu; Itou, Yoshihiro; Koga, Yutaka; Hashisako, Mikiko; Nozaki, Yui; Kiyozawa, Daisuke; Kitahara, Daichi; Inoue, Takeshi; Mukai, Munenori; Honda, Yumi; Toyokawa, Gouji; Tsuchihashi, Kenji; Matsushita, Yoshifumi; Fushimi, Fumiyoshi; Taguchi, Kenichi; Tamiya, Sadafumi; Oshiro, Yumi; Furue, Masutaka; Nakashima, Yasuharu; Suzuki, Satoshi; Iwaki, Toru; Oda, Yoshinao.
In: Virchows Archiv, Vol. 475, No. 4, 01.10.2019, p. 467-477.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinicopathological review of solitary fibrous tumors
T2 - dedifferentiation is a major cause of patient death
AU - Yamada, Yuichi
AU - Kohashi, Kenichi
AU - Kinoshita, Izumi
AU - Yamamoto, Hidetaka
AU - Iwasaki, Takeshi
AU - Yoshimoto, Masato
AU - Ishihara, Shin
AU - Toda, Yu
AU - Itou, Yoshihiro
AU - Koga, Yutaka
AU - Hashisako, Mikiko
AU - Nozaki, Yui
AU - Kiyozawa, Daisuke
AU - Kitahara, Daichi
AU - Inoue, Takeshi
AU - Mukai, Munenori
AU - Honda, Yumi
AU - Toyokawa, Gouji
AU - Tsuchihashi, Kenji
AU - Matsushita, Yoshifumi
AU - Fushimi, Fumiyoshi
AU - Taguchi, Kenichi
AU - Tamiya, Sadafumi
AU - Oshiro, Yumi
AU - Furue, Masutaka
AU - Nakashima, Yasuharu
AU - Suzuki, Satoshi
AU - Iwaki, Toru
AU - Oda, Yoshinao
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Solitary fibrous tumor (SFT) is a soft-tissue neoplasm of intermediate malignant potential, presenting a wide histopathological spectrum. Poorer prognosis of hemangiopericytoma of the central nervous system (CNS), hypoglycemic SFT, and dedifferentiation are well-known characters of SFT, but their clinical significance were not demonstrated enough by large-sized study. Here, the clinicopathological features of SFTs are reviewed and the relationship between genetics and clinicopathological features is examined using 145 SFT cases. All cases were STAT6 IHC-positive and/or NAB2-STAT6 fusion gene-positive. Tumor location was classified into three categories: 30 pleuropulmonary, 96 non-pleuropulmonary/non-central nervous system (CNS), and 18 CNS tumors. The tumor developed recurrence in 21 of 93 available cases (22.5%), metastasis in 11 of 93 (11.8%), and tumor death in 9 of 93 (9.6%). Hypoglycemia occurred in 2 primary tumors and 1 metastatic tumor among 63 reviewable cases, and dedifferentiation occurred in 10 cases (6.8%) including 6 primary tumors, 2 recurrent tumors, and 2 metastatic tumors. Recurrence was positively associated with CNS location (p = 0.0109) and hypoglycemia (p = 0.001); metastasis was positively associated with CNS location (p = 0.0231), hypoglycemia (p < 0.0001), and dedifferentiation (p < 0.0001), while metastasis was negatively correlated with pleural location (p = 0.0471). Tumor death was positively associated with male sex (p = 0.0154), larger size (p = 0.0455), hypoglycemia (p < 0.0001), and dedifferentiation (p < 0.0001). Multivariate analysis revealed independent statistical significance of dedifferentiation for overall survival (p = 0.0467). Exon variant of the fusion gene had no statistical correlation with clinical outcome. In conclusion, dedifferentiation is a major prognostic factor of SFT, and specific location such as cerebromeningeal and intra-abdominal site and hypoglycemia also had a high risk for unfavorable prognosis.
AB - Solitary fibrous tumor (SFT) is a soft-tissue neoplasm of intermediate malignant potential, presenting a wide histopathological spectrum. Poorer prognosis of hemangiopericytoma of the central nervous system (CNS), hypoglycemic SFT, and dedifferentiation are well-known characters of SFT, but their clinical significance were not demonstrated enough by large-sized study. Here, the clinicopathological features of SFTs are reviewed and the relationship between genetics and clinicopathological features is examined using 145 SFT cases. All cases were STAT6 IHC-positive and/or NAB2-STAT6 fusion gene-positive. Tumor location was classified into three categories: 30 pleuropulmonary, 96 non-pleuropulmonary/non-central nervous system (CNS), and 18 CNS tumors. The tumor developed recurrence in 21 of 93 available cases (22.5%), metastasis in 11 of 93 (11.8%), and tumor death in 9 of 93 (9.6%). Hypoglycemia occurred in 2 primary tumors and 1 metastatic tumor among 63 reviewable cases, and dedifferentiation occurred in 10 cases (6.8%) including 6 primary tumors, 2 recurrent tumors, and 2 metastatic tumors. Recurrence was positively associated with CNS location (p = 0.0109) and hypoglycemia (p = 0.001); metastasis was positively associated with CNS location (p = 0.0231), hypoglycemia (p < 0.0001), and dedifferentiation (p < 0.0001), while metastasis was negatively correlated with pleural location (p = 0.0471). Tumor death was positively associated with male sex (p = 0.0154), larger size (p = 0.0455), hypoglycemia (p < 0.0001), and dedifferentiation (p < 0.0001). Multivariate analysis revealed independent statistical significance of dedifferentiation for overall survival (p = 0.0467). Exon variant of the fusion gene had no statistical correlation with clinical outcome. In conclusion, dedifferentiation is a major prognostic factor of SFT, and specific location such as cerebromeningeal and intra-abdominal site and hypoglycemia also had a high risk for unfavorable prognosis.
UR - http://www.scopus.com/inward/record.url?scp=85070213177&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85070213177&partnerID=8YFLogxK
U2 - 10.1007/s00428-019-02622-9
DO - 10.1007/s00428-019-02622-9
M3 - Article
C2 - 31392468
AN - SCOPUS:85070213177
VL - 475
SP - 467
EP - 477
JO - Virchows Archiv
JF - Virchows Archiv
SN - 0945-6317
IS - 4
ER -