The management of solitary fibrous tumours; a retrospective review and suggestions for improvement

Introduction and aims Solitary fibrous tumours (SFT) are rare soft tissue sarcomas. Challenges in management include the variation in anatomical location and uncertain malignant potential. We retrospectively reviewed our experience with the aim of formulating guidelines on appropriate treatment. Methods An electronic database identified patients with SFT presenting between 2003–2011. Clinical records were reviewed. Results 23 patients were identified. Mean age was 50.6 years (12–77 years). The anatomic location was lower limb in 8, upper limb 4, intrathoracic 3, retroperitoneal 3, buttock and perianal regions 2, pelvis 1, thoracic spine 1 and brain 1. 10 cases were histologically benign, 5 had malignant potential and 8 were malignant. In 12 cases there was a complete surgical resection. In 6 cases there was a positive margin or piecemeal excision. There were 4 local recurrences and 5 patients with metastases. Completeness of record keeping varied with times and surgical speciality. Conclusions SFT occur infrequently, are difficult to diagnose, have an unpredictable course and present to a variety of surgical specialists. In order to improve outcomes, we recommend surgical and histological margins are accurately recorded and audited whatever surgical specialty leads the surgery, ideally within a sarcoma MDT. Complete resection at first attempt by specialists with an understanding of the need for complete resection is the goal.