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间变性血管外皮细胞瘤的预后因素、生存率及治疗分析

Analysis of Prognostic Factors, Survival Rates, and Treatment in Anaplastic Hemangiopericytoma.

作者信息

Zhang Gui-Jun, Zhang Li-Wei, Li Da, Wu Zhen, Zhang Jun-Ting

机构信息

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.

出版信息

World Neurosurg. 2017 Aug;104:795-801. doi: 10.1016/j.wneu.2017.05.092. Epub 2017 May 25.

Abstract

OBJECTIVE

In this study, we aimed to identify prognostic factors in anaplastic hemangiopericytoma (AHPC) and clinical behaviors that differentiate primary and secondary AHPC.

METHODS

The clinical data associated with 52 cases of AHPC that were surgically treated between 2008 and 2015 were reviewed. The patients were classified into the following 2 groups: primary AHPC (AHPC diagnosed at the first surgery) and secondary AHPC (malignant transformation from a lower-grade tumor).

RESULTS

The study included 27 men and 25 women. The participants had a mean age of 43 years old. The 3- and 5-year progression-free survival (PFS) rates were 63.4% and 53.5%, respectively, and the corresponding overall survival rates were 78.7% and 70.9%, respectively. At the final follow-up, there were 22 (42.3%) recurrences, 4 (7.7%) extracranial metastases, and 11 (21.2%) deaths. On the basis of multivariate analysis, primary AHPC (hazard ratio [HR] = 0.293, 95% CI 0.122-0.705) and postoperative radiotherapy (PRT) (HR = 0.372, 95% confidence interval [CI] 0.148-0.932; P = 0.035) were significantly associated with increased PFS, and gross total resection (HR = 3.512, 95% CI 1.060-11.634; P = 0.040) and PRT (HR = 0.165, 95% CI 0.035-0.771; P = 0.022) were independent favorable factors for overall survival.

CONCLUSION

Gross total resection and PRT following surgery are recommended in AHPC. Identifying clinical behaviors that differentiate primary and secondary AHPC improved our understanding of this type of tumor and guided treatment strategies.

摘要

目的

在本研究中,我们旨在确定间变性血管外皮细胞瘤(AHPC)的预后因素以及区分原发性和继发性AHPC的临床行为。

方法

回顾了2008年至2015年间接受手术治疗的52例AHPC患者的临床资料。患者被分为以下两组:原发性AHPC(首次手术时诊断为AHPC)和继发性AHPC(由低级别肿瘤恶变而来)。

结果

该研究纳入了27名男性和25名女性。参与者的平均年龄为43岁。3年和5年无进展生存率(PFS)分别为63.4%和53.5%,相应的总生存率分别为78.7%和70.9%。在最后一次随访时,有22例(42.3%)复发,4例(7.7%)颅外转移,11例(21.2%)死亡。基于多因素分析,原发性AHPC(风险比[HR]=0.293,95%置信区间[CI]0.122 - 0.705)和术后放疗(PRT)(HR = 0.372,95%置信区间[CI]0.148 - 0.932;P = 0.035)与PFS增加显著相关,而全切术(HR = 3.512,95% CI 1.060 - 11.634;P = 0.040)和PRT(HR = 0.165,95% CI 0.035 - 0.771;P = 0.022)是总生存的独立有利因素。

结论

推荐对AHPC进行术后全切术和PRT。识别区分原发性和继发性AHPC的临床行为有助于提高我们对这类肿瘤的认识并指导治疗策略。

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