CHEST Guidelines-Response_chest

Response_chest_9

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This document comprises a correspondence and response regarding the validation and application of a scoring system intended to predict the recurrence of solitary fibrous tumors of the pleura (SFTPs) following resection. Dr. Lococo and colleagues cite 12 recurrences (30%) in a high-risk cohort versus none in a low-risk group, supporting the Tapias score's predictive power. However, they express concern over the small sample size, suggesting the results aren't robust despite the Tapias score being a positive advancement in understanding SFTPs' behavior. They recommend further studies with larger, more homogeneous datasets focusing on recurrence rates to improve prognostic stratification, including variables like chest wall invasion and malignant pleural effusion.<br /><br />Responding, Dr. Tapias and Dr. Lanuti acknowledge that while the recurrence numbers are small, this results from the low incidence of SFTPs, which limits large sample sizes and prospective studies. Despite these constraints, the Tapias score has been applied to three independent patient cohorts, proving effective in classifying recurrence risk. They contest the view that their cohort didn't represent the full spectrum of SFTP biology, explaining that excluding patients with widespread or incompletely resected tumors was necessary but did not hinder the scoring system's applicability. They agree with Lococo et al.'s recommendation to include more clinical and molecular parameters for enhanced prediction accuracy in future studies. <br /><br />This exchange highlights the current limitations in SFTP research due to small sample sizes and suggests directions for improving predictive models, emphasizing the potential role of additional clinical and molecular factors in refining recurrence risk assessments.

Keywords

solitary fibrous tumors

pleura

recurrence prediction

Tapias score

validation

prognostic stratification

chest wall invasion

malignant pleural effusion

clinical parameters

molecular factors