Marginal Resection Is Appropriate for Radical Surgery for Solitary Fibrous Tumours of the Pelvis: A High Volume Pelvic Exenteration Centre Experience

Solitary fibrous tumours (SFTs) are rare soft-tissue neoplasms with variable metastatic potential and a tendency to exhibit more aggressive behaviour in the pelvis. This study evaluated the outcomes of pelvic SFT resections using a marginal resection approach at a specialist sarcoma and pelvic oncology centre. Eighteen patients underwent resection of pelvic SFTs between 1994 and 2025. Fifteen (83%) cases required resection of adjacent pelvic structures, of which three (17%) patients underwent total pelvic exenteration to achieve complete resection or to facilitate surgical access. Clear (R0) margins were achieved in 69% of cases, although most were ≤ 1 mm (IQR: 0.30-4.75). Major complications occurred in two patients (11%), and there was no inpatient or 30-day mortality. After a median follow-up of 42 months, 14 of 15 surviving patients were disease-free and only 2 patients experienced recurrence. These findings suggest that pelvic SFTs may be safely resected with low recurrence using a marginal resection approach.