Therapeutics and Clinical Risk Management (Sep 2022)

Intracranial Solitary Fibrous Tumor/Hemangiopericytoma Treated with Microsurgical Resection: Retrospective Cohort Analysis of a Single-Center Experience

  • Swaminathan S,
  • Ruzevick J,
  • Venur V,
  • Halasz LM,
  • Rockhill J,
  • Gonzalez-Cuyar L,
  • Cranmer LD,
  • Ferreira Jnr M

Journal volume & issue
Vol. Volume 18
pp. 901 – 912

Abstract

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Shreya Swaminathan,1,* Jacob Ruzevick,1,* Vyshak Venur,2 Lia M Halasz,3 Jason Rockhill,3 Luis Gonzalez-Cuyar,4 Lee D Cranmer,2 Manuel Ferreira Jnr1 1Department of Neurological Surgery, The University of Washington School of Medicine, Seattle, WA, USA; 2Division of Medical Oncology, Department of Medicine, The University of Washington School of Medicine, Seattle, WA, USA; 3Department of Radiation Oncology, The University of Washington School of Medicine, Seattle, WA, USA; 4Department of Laboratory Medicine and Pathology, Division of Neuropathology, The University of Washington School of Medicine, Seattle, WA, USA*These authors contributed equally to this workCorrespondence: Lee D Cranmer, University of Washington School of Medicine, Division of Medical Oncology, 825 Eastlake Ave. East, LG-350, Seattle, WA, 98109, USA, Tel +1 206 606-7439, Email [email protected]: To provide benchmarks for further studies of solitary fibrous tumor/hemangiopericytoma (SFT/HPC) of the central nervous system (CNS), we investigated the association of baseline demographic, clinico-pathologic, and treatment factors with outcomes in those treated at our center.Methods: We conducted a retrospective, cohort analysis of patients treated for SFT/HPC at the University of Washington 1990– 2020. Kaplan-Meier and univariable Cox analyses assessed relationships between baseline variables and local or global CNS recurrence, extraneural recurrence, progression-free survival (PFS) and overall survival (OS).Results: Among 34 eligible patients, median duration of follow-up was 79 months (range 13– 318 months). Local and global CNS recurrence occurred at a median of 81 m (95% CI 48– 151) and 81 m (95% CI 47– 112), respectively. Extraneural metastases occurred at a median 248 m (95% CI 180-Not Reached) and only in grade 3 tumors. Median PFS and OS were 76 months (95% CI: 47– 109 months) and 210 months (95% CI 131– 306 months), respectively. Univariable Cox analyses showed that age at diagnosis was associated with local (p = 0.01) and global CNS relapse (p = 0.01), and PFS (p = 0.03). Gross total resection was associated with decreased local or global CNS relapse (p = 0.02) and improved PFS (p = 0.03); peri-operative radiation was associated with decreased local CNS relapse (p = 0.02).Conclusion: Following microsurgical resection of SFT/HPC, CNS relapse is common and associated with age, extent of resection, and adjuvant radiation. Extraneural relapse occurs in some patients. Delayed time-to-initial relapse justifies prolonged surveillance, but optimal approaches have not been defined.Keywords: solitary fibrous tumor, hemangiopericytoma, radiotherapy, embolization, adjuvant

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