Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Department of Neuropathology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
J Neurooncol. 2023 Sep;164(2):397-404. doi: 10.1007/s11060-023-04437-w. Epub 2023 Aug 31.
Primary intracranial angiosarcomas (PIAs) are exceedingly uncommon, with the literature predominantly comprising case reports. The clinical characteristics and prognosis of this condition remain elusive. Our objective is to describe the clinical characteristics and surgical prognosis of this rare disease while offering insights into the most effective contemporary treatment strategy.
The authors of this article incorporated a cohort of 28 cases of PIAs, consisting of 3 from our institution and 25 from previously documented literature sources. Subsequently, we conducted both Cox univariate and multivariate analyses to assess the potential risk factors influencing overall survival (OS).
The cohort include 19 males and 9 females with a mean age of 39.6 ± 23.5 years (range: 0.03-73 years). Radiologically, 24 cases were located at supratentorial area, while only 4 cases were located at infratentorial area. 17 cases underwent gross total resection (GTR), and 11 cases underwent Non-GTR. Postoperative radiotherapy was administered to 17 cases, and postoperative chemotherapy was administered to 6 cases. After a mean follow-up time of 21.5 ± 26.4 months, 19 (67.9%) patients died. The 1-year, 2-year, 5-year OS is 55.3%, 50.7% and 24.6%, respectively. Univariate and multivariate Cox regression analysis showed that Non-GTR was the sole factor predicting a shorter OS (p = 0.004).
In this study, we found that PIAs have a higher incidence in males than in females, and most cases show evidence of old hemorrhage on preoperative MRI. Through our statistical analysis, GTR plays a crucial role in for treating this rare disease. Further clinical data are needed to validate our conclusions.
原发性颅内血管肉瘤(PIAs)极为罕见,文献主要为病例报告。该疾病的临床特征和预后仍不清楚。我们的目的是描述这种罕见疾病的临床特征和手术预后,并提供对当前最有效治疗策略的见解。
本文作者纳入了 28 例 PIA 病例,其中 3 例来自我们机构,25 例来自先前记录的文献来源。随后,我们进行了 Cox 单因素和多因素分析,以评估影响总生存率(OS)的潜在风险因素。
该队列包括 19 名男性和 9 名女性,平均年龄为 39.6±23.5 岁(范围:0.03-73 岁)。影像学上,24 例位于幕上区域,仅 4 例位于幕下区域。17 例接受了大体全切除(GTR),11 例接受了非 GTR。17 例术后接受了放疗,6 例术后接受了化疗。在平均 21.5±26.4 个月的随访后,19 例(67.9%)患者死亡。1 年、2 年和 5 年的 OS 分别为 55.3%、50.7%和 24.6%。单因素和多因素 Cox 回归分析表明,非 GTR 是预测 OS 较短的唯一因素(p=0.004)。
在这项研究中,我们发现 PIAs 在男性中的发病率高于女性,大多数病例在术前 MRI 上显示陈旧性出血的证据。通过我们的统计分析,GTR 在治疗这种罕见疾病中起着至关重要的作用。需要进一步的临床数据来验证我们的结论。