Clinical Features And Treatment Of Intracranial Hemangiopericytoma

Objective:Investigate intracranial hemangiopericytoma(HPC)and analyze the prognostic factors to guide clinical diagnosis and treatment.Methods:1.Medical records:The clinical manifestations,neuroradiological findings,surgical treatments,pathological features and follow-up data of 21 surgery patients diagnosed HPC were collected and analyzed retrospectively,who had undergone surgery in neurosurgery of Shandong University Qilu Hospital between Jan 2008 and Dec 2016.2.Surgery therapy:All patients accepted surgery.some of which accepted radiotherapy and synchronous chemotherapy.3.Pathological examination:All tumor samples were conducted by paraffin section and immunohistochemical staining.Pathological diagnosis was depended on 2007 version of WHO classification of the central nervous system tumors.4.Follow up:Brain CT or MRI were conducted in all patients after surgery and during follow up to identify surgical effects and whether tumor relapsed.5.Statistical analysis:The Kaplan-meier estimator was used to evaluate the patients' data.Results:There is no gender difference in our subjects.The age of patients ranged from 26 to 70 years old.The courses of disease ranged from 6 days to 21 years.There is no specific clinical manifestations,the majorities of which were intracranial hypertension and vision lesions.Tumors on imaging examinations showed unequally or mixed signals,solid cystic changes and unregularly form.The diameters of tumors ranged from 1.5 to 7 cm.Tumors were largely distributed in convexity and beside the cerebral falx,sinus,or in the cranial base.Operative approaches were based on the tumor locations.Follow-up period ranged from 12 months to 108 months.9 patients were conducted Simpson ? grade resection,2 of which relapsed during follow-up.5 patients were conducted Simpson ? grade resection,3 of which relapsed.7 patients were conducted Simpson ? grade resection and so on.all of which relapsed during follow-up.The differences of these recurrence rates were significant(p=0.002<0.05).The recurrence rate of whose Ki-67<5 was significantly lower than those Ki-67>5(p=0.019<0.05).Single factor analysis showed that tumor resection degree and Ki-67 were correlated with relapse and prognosis.However,multiple-factor analysis showed that only tumor resection degree was closely correlated with relapse and prognosis.When considered about clinical conditions and our subjects and data,we supposed that tumor resection degree and Ki-67 were both correlated with disease relapse.Conclusions:Total surgical excision was the primary treatment for intracranial HPC.Furthermore,tumor resection degree and Ki-67 were dominantly correlated with prognosis.Simpson ? grade and above grades?Ki-67>5 were risk factors of HCP relapse and poor prognosis.Accomplishment of Simpson 1 grade recession at the first surgical treatment is of vital importance to prevent relapse of HPC.