Gui-Jun Zhang1, Li-Wei Zhang1, Da Li2, Zhen Wu3, Jun-Ting Zhang4. 1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. 2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. Electronic address: lidaatlas@aliyun.com. 3. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. Electronic address: ttyywuzhen@sina.com. 4. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. Electronic address: zhangjunting2003@aliyun.com.
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.
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.
Authors: Sumanth Reddy; Aaron Plitt; Jack Raisanen; Ankur R Patel; Purva Gopal; Robert Timmerman; Toral R Patel Journal: Surg Neurol Int Date: 2019-07-26