Chen Long, Xiong Zujian, Zhou Yian, Li Yanwen, Xie Yuanyang, Xiong Yi, Wanggou Siyi, Li Xuejun
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.
Xiangya School of Medicine, Central South University, Changsha, China.
Front Surg. 2023 Jan 24;9:1092140. doi: 10.3389/fsurg.2022.1092140. eCollection 2022.
Supratentorial hemangioblastoma is an extremely rare neoplasm. The aim of this study is to delineate the clinical features among cystic and solid supratentorial hemangioblastoma patients and evaluate the risk factors for progression-free survival (PFS).
We conducted a literature search in PubMed for histopathologically identified supratentorial hemangioblastoma between 1947 and 2021 and extracted and collected the clinical features of patients treated at our own institute. The rate of PFS was determined using Kaplan-Meier analysis. Differences in categorical factors, such as the location of tumor and diagnosis of von Hippel-Lindau disease, were analyzed using the Pearson test. A Cox regression analysis was performed to evaluate the association between various variates and survival outcomes.
A total of 237 cases of supratentorial hemangioblastoma were identified from 169 studies. A survival analysis found that patients with cystic tumors had a significantly better prognosis than those with solid tumors (log-rank, = 0.0122). Cox regression analysis suggested that cystic hemangioblastoma (hazard ratio (HR): 0.186, 95% CI: 0.043-0.803, < 0.05) and gross total resection (GTR) (HR: 0.126, 95% CI: 0.049-0.323, < 0.001) were significant predictors of longer survival (PFS) for supratentorial hemangioblastoma. Following an analysis of 13 supratentorial hemangioblastoma cases from our institute, we validated that cystic tumor had improved prognosis than solid tumor (log-rank, = 0.0096) and GTR was superior to subtotal resection (log-rank, = 0.0029).
Cystic hemangioblastoma vs. solid hemangioblastoma may be two tumoral statuses with different clinical features, and a specific treatment strategy should be considered.
幕上血管母细胞瘤是一种极其罕见的肿瘤。本研究的目的是描述囊性和实性幕上血管母细胞瘤患者的临床特征,并评估无进展生存期(PFS)的危险因素。
我们在PubMed上检索了1947年至2021年间经组织病理学确诊的幕上血管母细胞瘤,并提取和收集了在我们研究所接受治疗的患者的临床特征。使用Kaplan-Meier分析确定PFS率。使用Pearson检验分析分类因素的差异,如肿瘤位置和冯·希佩尔-林道病的诊断。进行Cox回归分析以评估各种变量与生存结果之间的关联。
从169项研究中总共鉴定出237例幕上血管母细胞瘤病例。生存分析发现,囊性肿瘤患者的预后明显优于实性肿瘤患者(对数秩检验,P = 0.0122)。Cox回归分析表明,囊性血管母细胞瘤(风险比(HR):0.186,95%置信区间:0.043 - 0.803,P < 0.05)和全切除(GTR)(HR:0.126,95%置信区间:0.049 - 0.323,P < 0.001)是幕上血管母细胞瘤患者更长生存期(PFS)的显著预测因素。在分析了我们研究所的13例幕上血管母细胞瘤病例后,我们验证了囊性肿瘤的预后优于实性肿瘤(对数秩检验,P = 0.0096),且GTR优于次全切除(对数秩检验,P = 0.0029)。
囊性血管母细胞瘤与实性血管母细胞瘤可能是具有不同临床特征的两种肿瘤状态,应考虑特定的治疗策略。