Champeaux C, Rousseau P, Devaux B, Nataf F, Tauziède-Espariat A
Department of neurosurgery, Sainte-Anne hospital, 1, rue Cabanis, 75014 Paris, France.
Faculté de médecine, université de Montréal, 2900, boulevard Edouard-Montpetit, Montréal (Québec) H3T 1J4, Canada.
Neurochirurgie. 2018 Mar;64(1):37-43. doi: 10.1016/j.neuchi.2017.10.004. Epub 2018 Feb 21.
To report on the outcome of patients diagnosed with central nervous system haemangiopericytoma (HPC) or solitary fibrous tumours (SFT) and identify factors that may influence recurrence and survival.
Between January 1977 and December 2016, a retrospective search identified 22 HPCs/SFTs. The patients underwent a total of 40 surgical resections and 63.6% received radiotherapy. Median follow-up was 7.8 years.
Six patients (27.3%) were re-operated for tumour recurrence. At the end of the study, 15 patients (68.2%) had no residual tumour on the last imaging. Surgical recurrence-free survival at 5 years was 77.4%, [95% CI: 60.1-99.8]. None of the investigated variables was associated with recurrence. At the end of the study, 5 patients were deceased (22.7%) and only 10 patients (45.5%) had no residual tumour on the last imaging and were alive. Overall survival at 5 years was 95%, [95% CI: 85.9-100]. None of the investigated variables was associated with overall survival. Patients who received radiotherapy demonstrated neither a reduced risk of surgical recurrence (P=0.378) nor a longer overall survival (P=0.405).
SFTs/HPCs are associated with a significant risk of recurrence that may reduce the survival. Even if we could not demonstrate their benefit in this limited series, we believe that tailored maximal tumour resection on initial surgery is beneficial and that adjuvant RT is useful for tumours displaying grade II or III, even in case of complete removal.
报告诊断为中枢神经系统血管外皮细胞瘤(HPC)或孤立性纤维性肿瘤(SFT)的患者的治疗结果,并确定可能影响复发和生存的因素。
在1977年1月至2016年12月期间,通过回顾性检索确定了22例HPC/SFT患者。这些患者共接受了40次手术切除,63.6%接受了放疗。中位随访时间为7.8年。
6例患者(27.3%)因肿瘤复发接受了再次手术。在研究结束时,15例患者(68.2%)在最后一次影像学检查中无残留肿瘤。5年手术无复发生存率为77.4%,[95%可信区间:60.1-99.8]。所研究的变量均与复发无关。在研究结束时,5例患者死亡(22.7%),只有10例患者(45.5%)在最后一次影像学检查中无残留肿瘤且存活。5年总生存率为95%,[95%可信区间:85.9-100]。所研究的变量均与总生存无关。接受放疗的患者手术复发风险既未降低(P=0.378),总生存时间也未延长(P=0.405)。
SFTs/HPCs具有显著的复发风险,这可能会降低生存率。即使在这个有限的系列研究中我们未能证明其益处,但我们认为在初次手术时进行量身定制的最大程度肿瘤切除是有益的,辅助放疗对显示为II级或III级的肿瘤有用,即使肿瘤已完全切除。