Long-Term Outcome and Prognostic Factors After Repeated Surgeries for Intracranial Hemangiopericytomas.

OBJECTIVE

The goals of the present study were to identify predictors of better survival and to propose appropriate management strategies for recurrent hemangiopericytomas (HPC) and anaplastic hemangiopericytomas (AHPC).

METHODS

Between 2008 and 2016, 191 patients underwent surgeries for HPC and/or AHPC at our institute, and during follow-up the tumors recurred in 57 patients, including 31 males (54.4%).

RESULTS

At the first recurrence, 30 patients (52.6%) underwent surgery, 25 patients (43.9%) declined surgery, and 2 patients (3.5%) received Gamma Knife treatment. The 1-year, 3-year, and 5-year actuarial rates of second progression-free survival in the HPC group were 73.3%, 46.7%, and 24.9%, respectively; the rates in the AHPC group were 66.7%, 66.7%, and 0%, respectively. The actuarial 1-year, 3-year, and 5-year overall survival rates of HPC after the first recurrence were 87.4%, 69.2%, and 39.5%, respectively; in the AHPC group, the rates were 85.2%, 45.9%, and 24.5%, respectively. Each 1-month increase in the time interval from first surgery to first recurrence (first recurrence-free survival) (hazard ratio, 0.972; 95% confidence interval, 0.952-0.993; P = 0.010) was strongly associated with better overall survival. Patients who received surgery with or without radiation at their first recurrence survived longer than patients who did not (estimated median survival time, 53.0 months vs. 35.7 months; P = 0.028).

CONCLUSIONS

Treatment is imperative for the first recurrence of HPC or AHPC. More attention should be paid to patients with shorter first recurrence-free survival. Surgery is the first choice for their first recurrence and radiotherapy should be administered if there is no history of radiotherapy.