Resultados en el tratamiento de los hemangiopericitomas intracraneanos. Serie de casos / Results in the treatment of intracranial hemangiopericytomas. Case series

Objetivo Los hemangiopericitomas intracraneanos (HPC) son tumores de muy baja frecuencia, alta recidiva local y riesgo de metástasis extracraneal. El objetivo del siguiente trabajo es presentar los resultados en el tratamiento de los HPC en nuestra institución en los últimos 20 años y realizar una revisión de la literatura del tema. Material y métodos Se realizó un estudio retrospectivo que incluyó a los pacientes con diagnóstico de tumor fibroso solitario/hemangiopericitoma (TFS/HPC) intracraneanos intervenidos quirúrgicamente en el periodo 1997-2017. Se incluyeron pacientes con inmunomarcación positiva para STAT-6 y grado histológico II-III. Se recabaron datos demográficos, características tumorales, tratamiento y sobrevida de estos pacientes. Resultados Un total de 19 pacientes cumplieron los criterios de inclusión. La mediana de seguimiento fue de 96 meses (12-230). La mortalidad fue del 21% (n = 4). El 57,9% presentaron al menos una recidiva tumoral (n = 11) (con una recurrencia del 6, del 67 y del 90% a 1, 5 y 10 años, respectivamente). Cinco pacientes presentaron metástasis extracraneal. Tuvieron mayor sobrevida los pacientes con tumores < 6 cm (p < 0,05). Conclusiones Se presentó una serie de pacientes operados de TFS/HPC según los nuevos criterios de la OMS. El tamaño es un factor predictor de sobrevida. Actualmente no existen criterios validados de resección quirúrgica en esta patología. Una clasificación con orientación quirúrgica sería de utilidad en el futuro (AU)

Objective Intracranial hemangiopericytoma (HPC) is a rare central nervous system tumor characterized by its low incidence, high rate of local recurrence and risk of metastasis. The main objectives of this paper are two: to show the results in the treatment of HPC in our institution in the last 20 years and to make a review of the literature on this topic. Methods Retrospective review that includes patients diagnosed with intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC) that have undergone surgery from 1997 to 2017. It includes patients that had nuclear expression of STAT-6 (detected by immunohistochemistry) and grade II/III histopathological diagnosis (defined by the World Health Organization in 2016). We collected demographic data, tumor characteristics, treatment and survival of these patients. Results A total of 19 patients fulfilled inclusion criteria. The median follow up was 96 months (12-230). The mortality rate was 21% (n = 4). 57.9% of patients presented at least one tumor recurrence (n = 11) (recurrences of 6%, 67% y 90% at 1, 5 and 10 years). Five patients presented extracranial metastasis. Patients with tumors < 6 cm had greater survival (P < .05). Conclusions A series of patients undergoing SFT/HPC were presented according to the new WHO criteria. Size is a predictor of survival. Currently there are no validated criteria for surgical resection in this pathology. A classification with surgical guidance would be useful (AU)

Results in the treatment of intracranial hemangiopericytomas. Case series. / Resultados en el tratamiento de los hemangiopericitomas intracraneanos. Serie de casos.

OBJECTIVE: Intracranial hemangiopericytoma (HPC) is a rare central nervous system tumor characterized by its low incidence, high rate of local recurrence and risk of metastasis. The main objectives of this paper are two: to show the results in the treatment of HPC in our institution in the last 20years and to make a review of the literature on this topic. METHODS: Retrospective review that includes patients diagnosed with intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC) that have undergone surgery from 1997 to 2017. It includes patients that had nuclear expression of STAT-6 (detected by immunohistochemistry) and gradeII/III histopathological diagnosis (defined by the World Health Organization in 2016). We collected demographic data, tumor characteristics, treatment and survival of these patients. RESULTS: A total of 19 patients fulfilled inclusion criteria. The median follow up was 96 months (12-230). The mortality rate was 21% (n=4). 57.9% of patients presented at least one tumor recurrence (n=11) (recurrences of 6%, 67% y 90% at 1, 5 and 10years). Five patients presented extracranial metastasis. Patients with tumors <6cm had greater survival (P<.05). CONCLUSIONS: A series of patients undergoing SFT/HPC were presented according to the new WHO criteria. Size is a predictor of survival. Currently there are no validated criteria for surgical resection in this pathology. A classification with surgical guidance would be useful.

Management of meningeal solitary fibrous tumors/hemangiopericytoma; surgery alone or surgery plus postoperative radiotherapy?

INTRODUCTION: A meningeal solitary fibrous tumor (SFT), also called hemangiopericytoma, is a rare mesenchymal malignancy. Due to anatomic constrains, even after macroscopic complete surgery with curative intent, the local relapse risk is still relatively high, thus increasing the risk of dedifferentiation and metastatic spread. This study aims to better define the role of postoperative radiotherapy (RT) in meningeal SFTs. PATIENTS AND METHODS: A retrospective study was performed across seven sarcoma centers. Clinical information was retrieved from all adult patients with meningeal primary localized SFT treated between 1990 and 2018 with surgery alone (S) compared to those that also received postoperative RT (S + RT). Differences in treatment characteristics between subgroups were tested using independent samples t-test for continuous variables and chi-square tests for proportions. Local control (LC) and overall survival (OS) rates were calculated as time from start of treatment until progression or death from any cause. LC and OS in groups receiving S or S + RT were compared using Kaplan-Meier survival curves. RESULTS: Among a total of 48 patients, 7 (15%) underwent S and 41 (85%) underwent S + RT. Median FU was 65 months. LC was significantly associated with treatment. LC after S at 60 months was 60% versus 90% after S + RT (p = 0.052). Furthermore, R1 resection status was significantly associated with worse LC (HR 4.08, p = 0.038). OS was predominantly associated with the mitotic count (HR 3.10, p = 0.011). CONCLUSION: This retrospective study, investigating postoperative RT in primary localized meningeal SFT patients, suggests that combining RT to surgery in the management of this patient population may reduce the risk for local failures.