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

Abstract

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.

A rare case of intracranial solitary fibrous tumor that is still alive after multiple surgical resections: a case report and review of the literature

“…Follow-up and monitoring of SFT are inevitable recommendations (51). According to the research, longterm persistence in follow-up is rare among patients.…”

Conditional survival analysis and dynamic survival prediction for intracranial solitary-fibrous tumor/hemangiopericytoma

“…The recent studies had reported that the incidence of this tumor is increasing, and it required specialized medical attention (Lu et al 2022 ). As the form of classification is updated, there is a lack of research on prognostic factors and outcomes for combined SFT and HPC tumors, with previous studies often limited by small sample sizes and an inability to validate findings (Swaminathan et al 2022a ; Mena et al 1991 ; Rutkowski et al 2012 ; Zeng et al 2017 ; Wu et al 2021 ). Moreover, there is inadequate description regarding the survival pattern of SFT/HPC patients in contemporary time.…”

“…Moreover, there is inadequate description regarding the survival pattern of SFT/HPC patients in contemporary time. The survival description of this tumor is often based on a relatively small sample size and is generally targeted at overall survival (OS) (Wu et al 2021 ; Swaminathan et al 2022b ). Further investigation is required to determine the conditional survival (CS) of SFT/HPC.…”

Surgical Management of Craniospinal Axis Solitary Fibrous Tumors: A Single-Institution Case Series and Comprehensive Review of the Literature

“…6,7 SFTs are primarily discovered in middle-aged patients, with a mean age of 44 years at presentation and no predilection regarding sex. 8…”

“…6,7 SFTs are primarily discovered in middle-aged patients, with a mean age of 44 years at presentation and no predilection regarding sex. 8 In 2016, the World Health Organization (WHO) issued a designation combining SFTs and hemangiopericytomas (HPCs) into a single entity because of the sharing of genetic origins, a chromosomal inversion at the 12q13 locus leading to a NAB2:: STAT6 fusion product. 2,9,10 However, in the latest 2021 WHO Classification of Tumors of the CNS, the joint term "SFT/HPC" has been consolidated to "SFT."…”