The Clinical Characteristics And Prognostic Factors Of SFT/HPC In Central Nervous System

Objective To analyze the clinical characteristics of solitary fibrous tumor(SFT)/hemangiopericytoma(HPC)in the central nervous system(CNS),and to improve the understanding of solitary fibrous tumor / hemangiopericytoma,and to provide more references for the best clinical treatment plan.Methods The data of 77 patients with SFT/HPC in Department of Neurosurgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2013 to December 2019 were collected retrospectively.Data on clinical presentation,radiologic findings,pathologic features,surgical treatment and postoperative adjuvant treatment of patients with SFT / HPC in the central nervous system were retrospectively reviewed.The chi-square test,Kaplan-Meier curves and Cox regression analysis were used to identify the prognostic factors for postoperative recurrence risk and overall survival(OS).Results This study enrolled 36 male,and 41 female(1:1.14)with a mean age of46.04 ± 12.21 years;average diameter of tumor were 4.46 ± 1.94 cm;The total number of gross total resection were 48 cases(62.3%),of subtotal resection were 29cases(37.7%).17 patients(24.6%)underwent postoperative radiotherapy,1 patient(1.4%)underwent postoperative chemotherapy and 5 patients(7.2%)underwent gamma knife radiosurgery.There were 16 recurrences(23.2%),4 metastasises(5.8%),6 deaths(8.7%).Univariate analysis showed that age,location of tumor,tumor size and degree of surgical resection were the risk factors for recurrence(P<0.05).Statistical analysis showed that gender,World Health Organization(WHO)grade,ki67 index,postoperative radiotherapy and gamma knife radiosurgery were not associated with recurrence(P > 0.05).Multivariate analysis revealed independent risk factors affecting recurrence were tumor size(HR=0.602,95%CI 0.365-0.993;P =0.047)and degree of surgical resection(HR= 0.031,95%CI 0.003-0.357;P =0.005).The degree of surgical resection and WHO grade were the risk factors affecting OS(P<0.05).Statistical analysis showed that gender,age,tumor size,location of tumor,ki67 index were not associated with OS(P>0.05).Conclusion Solitary fibrous tumor / hemangiopericytoma in central nervous system usually causes headache and dizziness.The patients with large tumor size and high WHO grade indicates poor outcome.Improving the degree of surgical resection is an important way to improve the prognosis.There is no significant effect of adjuvant radiotherapy in terms of OS and progression free survival(PFS).