Analysis of clinical characteristics and prognostic factors of 102 cases of solitary fibrous tumors of the central nervous system
Objective To explore the clinical characteristics and prognostic factors of patients with solitary fibrous tumor(SFT)of the central nervous system.Methods The clinical data of 102 SFT patients who underwent surgical treatment at the Neurosurgery Center of Beijing Tiantan Hospital,Capital Medical University from January 2016 to December 2020 were retrospectively analyzed.The patients'clinical data,perioperative and postoperative brain MRI examination results,survival status and disease progression during the follow-up period,as well as the extent of tumor surgical resection and pathological examination results were collected.The life table method was used to calculate the progression-free survival rate and overall survival rate at 1,3,and 5 years.The log-rank test was used to compare the survival distribution of patients with different age,World Health Organization(WHO)tumor grade,surgical resection degree,maximum tumor diameter,and tumor location grouping,and to compare whether there was peritumoral edema before surgery and whether the tumor was unevenly enhanced after contrast administration,whether the tumor involved the venous sinus,whether the tumor invaded extracranially,and the survival distribution of patients with or without postoperative radiotherapy(PORT).Furthermore,a multivariate Cox proportional hazards model was used to conduct influencing factor analysis to determine the influencing factors of progression-free survival and overall survival.The log-rank test was used to compare the impact of different treatment strategies on the survival of SFT patients.Results The age of the 102 patients was 45.9±13.4 years old,and the male-to-female ratio was approximately 1.22:1.00.Among the 102 patients,67(65.7％)had tumors located on the supratentorial cerebellum,35(34.3％)located at the skull base;67 cases(65.7％)had peritumoral edema,62 cases(60.8％)had heterogeneous tumor contrast enhancement,53 cases(52.0％)involved venous sinuses,and 9 cases(8.8％)had extracranial invasion.After pathological examination,8 cases were WHO grade 1,49 cases were grade 2,and 45 cases were grade 3.Among the 102 patients,74 underwent total tumor resection(GTR),28 underwent subtotal resection(STR),and 57 underwent PORT.The median follow-up time of 102 patients was 48(35,66)months;by the last follow-up,30.4％(31/102)of patients had tumor recurrence;9.8％(10/102)died due to tumor progression,and 1.0％(1/102)died of postoperative complications;4.9％(5/102)patients developed distant metastasis.The progression-free survival rates of 102 patients at 1,3,and 5 years were 80％,67％,and 67％respectively;the overall survival rates at 1,3,and 5 years were 97％,91％,and 89％,respectively.The results of univariate analysis showed that patients with lower WHO grade,GTR,and tumors not involving venous sinuses had a higher progression-free survival rate(all P＜0.05);patients aged＜60 years and GTR had a higher overall survival rate(all P＜0.05).Multivariate Cox proportional hazards model analysis results showed that the tumor WHO grade 3(HR=4.45,95％CI:1.80-10.99,P＜0.001),STR(HR=9.82,95％CI:3.68-26.16,P＜0.001)were all risk factors for short progression-free survival in SFT patients;and STR was also a risk factor for short overall survival in SFT patients(HR=8.73,95％CI:1.70-44.90,P=0.010).Survival analysis of patients grouped by different treatment strategies showed that in the overall cohort,compared with the STR group(n=11),the progression-free survival rate of patients in the STR+PORT group(n=17)was higher(P=0.026).Among patients with tumors of WHO grade 3,compared with the GTR group(n=5),the progression-free survival rate of patients in the GTR+PORT group(n=23)was higher(P=0.029).Conclusions SFT of the central nervous system is more common in the supratentorial cerebellum,and is more common in WHO grades 2 and 3.Extracranial metastasis can occur,and the overall prognosis within 5 years after surgery is good.Patients whose tumors are WHO grade 3 and STR have shorter progression-free survival,and patients with STR have shorter overall survival.
Central nervous system neoplasmsDisease attributesPrognosisTreatment outcomeSolitary fibrous tumor
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