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Solitary-fibrous tumor/hemangiopericytoma of the central nervous system: a population-based study

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Abstract

The World Health Organization (WHO) classification of tumors of the central nervous system (CNS) was recently updated, restructuring solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) into one combined entity. This is the first population-based study to examine outcomes of SFT/HPC based on the new WHO guidelines. The Surveillance, Epidemiology, and End Results (SEER) database (1998–2013) was queried to examine age-adjusted incidence and prognostic factors associated with overall survival in 416 surgically resected cases. Age-adjusted incidence was calculated to be 3.77 per 10,000,000 and was rising. Median survival was 155 months, with 5- and 10-year survival rates of 78 and 61%, respectively. Younger age, Asian/Pacific Islander versus white race, benign histology, tumor location, gross-total resection (GTR), and GTR plus radiation (RT) versus subtotal resection were significantly associated with survival. In multivariable analysis, older age (HR = 1.038, p < 0.0001), infratentorial location (HR = 2.019, p = 0.038), GTR (HR = 0.313, p = 0.041), and GTR + RT (HR = 0.215, p = 0.008) were independent prognostic factors. In the HPC and borderline/malignant subgroups, GTR + RT was associated with significantly increased survival compared with GTR alone (HR = 0.537, p = 0.039 and HR = 0.525, p = 0.038). After eliminating patients that died within 3 months of diagnosis, GTR + RT was still associated with an incremental increase in survival (HR = 0.238, p = 0.031) over GTR alone (HR = 0.280, p = 0.054). GTR + RT may be optimal in the management CNS HPC and SFT/HPC tumors with borderline/malignant features. This study, in combination with existing literature, warrants further investigation of adjuvant radiation through a prospective clinical trial.

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Acknowledgements

We would like to thank the developers of the Surveillance, Epidemiology, and End Results program.

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Authors and Affiliations

  1. Department of Radiation Oncology, Columbia University Medical Center, 622 West 168th Street, BNH B011, New York, NY, 10032, USA

    Connor J. Kinslow & Tony J. C. Wang

  2. Department of Neurological Surgery, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA

    Samuel S. Bruce, Ali I. Rae, Sameer A. Sheth, Guy M. McKhann, Michael B. Sisti & Jeffrey N. Bruce

  3. Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA

    Sameer A. Sheth, Guy M. McKhann, Michael B. Sisti, Jeffrey N. Bruce & Tony J. C. Wang

  4. Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Adam M. Sonabend

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Correspondence to Tony J. C. Wang.

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Tony J. C. Wang reports personal fees and nonfinancial support from AbbVie, nonfinancial support from Merck, personal fees from AstraZeneca, personal fees from Doximity, nonfinancial support from Novocure, personal fees and nonfinancial support from Elekta and personal fees from Wolters Kluwer, outside the submitted work. All other authors report no financial conflicts of interest.

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Kinslow, C.J., Bruce, S.S., Rae, A.I. et al. Solitary-fibrous tumor/hemangiopericytoma of the central nervous system: a population-based study. J Neurooncol 138, 173–182 (2018). https://doi.org/10.1007/s11060-018-2787-7

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