Jiang Nian, Xie Yuan-Yang, Chen Wen, Peng Ze-Feng, Yuan Xian-Rui, Li Xue-Jun, Feng Cheng-Yuan, Wang-Gou Si-Yi
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
World Neurosurg. 2017 Mar;99:584-592. doi: 10.1016/j.wneu.2016.12.057. Epub 2016 Dec 23.
Solitary fibrous tumors (SFTs) are rare mesenchymal tumors that occasionally occur in the central nervous system (CNS). It is difficult to fully understand their clinical characteristics, partly due to a limited number of reported cases.
We reviewed 24 patients admitted to our institution between 2009 and 2016 with CNS solitary fibrous tumors. We reviewed and analyzed patient profiles, such as demographics, presentations, imaging studies, extent of resection, and adjuvant treatment. Differences between malignant and benign SFTs were assessed using the χ2 test or Student's t-test. Kaplan-Meier analysis was used to estimate the disease-free survival (DFS) rate. The multivariate Cox regression analysis was performed to evaluate the possible predictive value of the DFS rate of the previously mentioned covariates.
A total of 13 men and 11 women were enrolled in the study (the average age was 43). The median follow-up time was 58 months. Twenty-one patients underwent gross total resection (GTR), and 3 patients received a subtotal resection (STR). The tumors in 15 patients (62.5%) were atypical or malignant. One patient (4.2%) suffered SFT-related death (multiple organ failure by tumor metastasis), and 3 patients (12.5%) experienced tumor recurrence. We found that a large tumor size (≥10 cm, P < 0.001) and STR (P < 0.001) were negatively associated with the DFS rate.
CNS SFTs are rare, slow-growing, less aggressive, and recrudescent tumors. Complete resection is the most effective therapy. Large tumor size and STRs might shorten DFS time.
孤立性纤维瘤(SFTs)是罕见的间叶组织肿瘤,偶发于中枢神经系统(CNS)。由于报道的病例数量有限,很难全面了解其临床特征。
我们回顾了2009年至2016年间我院收治的24例中枢神经系统孤立性纤维瘤患者。我们回顾并分析了患者资料,如人口统计学特征、临床表现、影像学检查、切除范围及辅助治疗情况。采用χ²检验或Student's t检验评估恶性和良性SFTs之间的差异。采用Kaplan-Meier分析估计无病生存率(DFS)。进行多因素Cox回归分析以评估上述协变量对DFS率的可能预测价值。
本研究共纳入13例男性和11例女性(平均年龄43岁)。中位随访时间为58个月。21例患者接受了全切除(GTR),3例患者接受了次全切除(STR)。15例患者(62.5%)的肿瘤为非典型或恶性。1例患者(4.2%)死于SFT相关疾病(肿瘤转移导致多器官功能衰竭),3例患者(12.5%)出现肿瘤复发。我们发现肿瘤体积较大(≥10 cm,P<0.001)和次全切除(P<0.001)与DFS率呈负相关。
中枢神经系统SFTs是罕见的、生长缓慢、侵袭性较小且易复发的肿瘤。完整切除是最有效的治疗方法。肿瘤体积较大和次全切除可能会缩短DFS时间。