Analysis of Prognostic Factors, Survival Rates, and Treatment in Anaplastic Hemangiopericytoma

World Neurosurg. 2017 Aug:104:795-801. doi: 10.1016/j.wneu.2017.05.092. Epub 2017 May 25.

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.

Keywords: Anaplastic hemangiopericytoma; Prognosis; Radiotherapy; Recurrent risk factor.

MeSH terms

  • Adult
  • Brain Neoplasms / mortality*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / surgery*
  • Cell Transformation, Neoplastic / pathology
  • China
  • Combined Modality Therapy
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Hemangiopericytoma / mortality*
  • Hemangiopericytoma / pathology
  • Hemangiopericytoma / radiotherapy
  • Hemangiopericytoma / surgery*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / radiotherapy
  • Neoplasm Recurrence, Local / surgery
  • Neoplasms, Second Primary / mortality
  • Neoplasms, Second Primary / pathology
  • Neoplasms, Second Primary / radiotherapy
  • Neoplasms, Second Primary / surgery*
  • Radiotherapy, Adjuvant
  • Reoperation

Supplementary concepts

  • Hemangiopericytoma, Malignant