PDF(Pubmed)
Abstract：
UNASSIGNED: Solitary fibrous tumor (SFT) is a rare soft tissue tumor found at any site of the body. The treatment of choice is surgical resection, though 10%-30% of patients experience recurrent disease. Multiple risk factors and risk stratification systems have been investigated to predict which patients are at risk of recurrence. The main goal of this systematic review is to create an up-to-date systematic overview of risk factors and risk stratification systems predicting recurrence for patients with surgically resected SFT within torso and extremities.
UNASSIGNED: We prepared the review following the updated Prisma guidelines for systematic reviews (PRISMA-P). Pubmed, Embase, Cochrane Library, WHO international trial registry platform and ClinicalTrials.gov were systematically searched up to December 2022. All English studies describing risk factors for recurrence after resected SFT were included. We excluded SFT in the central nervous system and the oto-rhino-laryngology region.
UNASSIGNED: Eighty-one retrospective studies were identified. Different risk factors including age, symptoms, sex, resection margins, anatomic location, mitotic index, pleomorphism, hypercellularity, necrosis, size, dedifferentiation, CD-34 expression, Ki67 index and TP53-expression, APAF1-inactivation, TERT promoter mutation and NAB2::STAT6 fusion variants were investigated in a narrative manner. We found that high mitotic index, Ki67 index and presence of necrosis increased the risk of recurrence after surgically resected SFT, whereas other factors had more varying prognostic value. We also summarized the currently available different risk stratification systems, and found eight different systems with a varying degree of ability to stratify patients into low, intermediate or high recurrence risk.
UNASSIGNED: Mitotic index, necrosis and Ki67 index are the most solid risk factors for recurrence. TERT promoter mutation seems a promising component in future risk stratification models. The Demicco risk stratification system is the most validated and widely used, however the G-score model may appear to be superior due to longer follow-up time.
UNASSIGNED: CRD42023421358.
UNASSIGNED: We prepared the review following the updated Prisma guidelines for systematic reviews (PRISMA-P). Pubmed, Embase, Cochrane Library, WHO international trial registry platform and ClinicalTrials.gov were systematically searched up to December 2022. All English studies describing risk factors for recurrence after resected SFT were included. We excluded SFT in the central nervous system and the oto-rhino-laryngology region.
UNASSIGNED: Eighty-one retrospective studies were identified. Different risk factors including age, symptoms, sex, resection margins, anatomic location, mitotic index, pleomorphism, hypercellularity, necrosis, size, dedifferentiation, CD-34 expression, Ki67 index and TP53-expression, APAF1-inactivation, TERT promoter mutation and NAB2::STAT6 fusion variants were investigated in a narrative manner. We found that high mitotic index, Ki67 index and presence of necrosis increased the risk of recurrence after surgically resected SFT, whereas other factors had more varying prognostic value. We also summarized the currently available different risk stratification systems, and found eight different systems with a varying degree of ability to stratify patients into low, intermediate or high recurrence risk.
UNASSIGNED: Mitotic index, necrosis and Ki67 index are the most solid risk factors for recurrence. TERT promoter mutation seems a promising component in future risk stratification models. The Demicco risk stratification system is the most validated and widely used, however the G-score model may appear to be superior due to longer follow-up time.
UNASSIGNED: CRD42023421358.
摘要：
■孤立性纤维瘤（SFT）是一种罕见的软组织肿瘤，存在于身体的任何部位。选择的治疗方法是手术切除，尽管10%-30%的患者经历复发性疾病。已经研究了多种风险因素和风险分层系统以预测哪些患者有复发风险。本系统评价的主要目标是创建一个最新的风险因素和风险分层系统的系统概述，预测躯干和四肢内手术切除的SFT患者的复发。
■我们根据更新的Prisma系统评价指南（PRISMA-P）编写了评价。Pubmed,Embase,科克伦图书馆,截至2022年12月，对世卫组织国际试验注册平台和ClinicalTrials.gov进行了系统搜索。包括所有描述切除SFT后复发危险因素的英文研究。我们排除了中枢神经系统和耳鼻喉区域的SFT。
■确定了81项回顾性研究。不同的风险因素，包括年龄，症状,性别,切除边缘,解剖位置,有丝分裂指数,多态性，细胞过多,坏死,尺寸,去分化，CD-34表达式,Ki67指数和TP53表达，APAF1-失活,以叙述方式研究TERT启动子突变和NAB2::STAT6融合变体。我们发现高有丝分裂指数，Ki67指数和坏死的存在增加了手术切除SFT后复发的风险，而其他因素的预后价值差异较大.我们还总结了目前可用的不同风险分层系统，并发现八个不同的系统具有不同程度的将患者分层为低的能力，中度或高度复发风险。
■有丝分裂指数，坏死和Ki67指数是复发的最可靠危险因素。TERT启动子突变似乎是未来风险分层模型中一个有希望的组成部分。Demicco风险分层系统是最有效和广泛使用的，然而,由于随访时间较长,G评分模型可能看起来更优.
■CRD42023421358。
■我们根据更新的Prisma系统评价指南（PRISMA-P）编写了评价。Pubmed,Embase,科克伦图书馆,截至2022年12月，对世卫组织国际试验注册平台和ClinicalTrials.gov进行了系统搜索。包括所有描述切除SFT后复发危险因素的英文研究。我们排除了中枢神经系统和耳鼻喉区域的SFT。
■确定了81项回顾性研究。不同的风险因素，包括年龄，症状,性别,切除边缘,解剖位置,有丝分裂指数,多态性，细胞过多,坏死,尺寸,去分化，CD-34表达式,Ki67指数和TP53表达，APAF1-失活,以叙述方式研究TERT启动子突变和NAB2::STAT6融合变体。我们发现高有丝分裂指数，Ki67指数和坏死的存在增加了手术切除SFT后复发的风险，而其他因素的预后价值差异较大.我们还总结了目前可用的不同风险分层系统，并发现八个不同的系统具有不同程度的将患者分层为低的能力，中度或高度复发风险。
■有丝分裂指数，坏死和Ki67指数是复发的最可靠危险因素。TERT启动子突变似乎是未来风险分层模型中一个有希望的组成部分。Demicco风险分层系统是最有效和广泛使用的，然而,由于随访时间较长,G评分模型可能看起来更优.
■CRD42023421358。
