CHEST Guidelines-Tapias-Score-for-Predicting-Recurrences-in-Resecte

Tapias-Score-for-Predicting-Recurrences-in-Resecte

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The article discusses the Tapias score, a system proposed to predict recurrences in patients with resected solitary fibrous tumors of the pleura (SFTP), a rare condition with an unpredictable prognosis. Originally developed by Tapias et al., the score aims to standardize prognostic criteria, which had been unsuccessful before. This correspondence reports results from an external validation on a high-risk patient population, revealing that the Tapias score is a useful tool for recurrence prediction, particularly highlighting significant risk factors such as chest wall invasion and malignant pleural effusion.<br /><br />In their analysis of 43 eligible male patients with SFTP from a larger database, Tapias scores ranged from 2 to 6, with none having a score of 0. With a cutoff of score ≥3, 93% were classified as high risk for recurrence. Cox regression analysis showed a significant association between chest wall invasion, malignant pleural effusion, and increased risk of recurrence and death. Additionally, the completeness of resection was found to be a critical prognostic factor.<br /><br />Though the score is promising, the low number of observed recurrences (12 out of 43 in the validation group) limits its robustness, underscoring the need for larger studies. Another concern was the Tapias score's initial population wasn't wholly representative, with lower recurrence rates (8%) compared to the high-risk group in the validation study (27.9%).<br /><br />The Tapias score provides a foundation for improving the understanding and management of SFTP. Future suggestions include conducting studies with more homogeneous patient datasets and considering other clinical features such as chest wall invasion and pleural effusion for more accurate prognostic stratifications post-surgery. The response from the original authors appreciates this validation effort and acknowledges the challenges but supports the method's potential in classifying risk efficiently under current constraints.

Keywords

Tapias score

solitary fibrous tumors

pleura

recurrence prediction

chest wall invasion

malignant pleural effusion

prognostic criteria

external validation

high-risk patients

completeness of resection