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Spinal location is prognostic of survival for solitary-fibrous tumor/hemangiopericytoma of the central nervous system

  • Clinical Study
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Abstract

Background

Prior studies have highlighted infratentorial tumor location as a prognostic factor for solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) of the central nervous system (CNS), and spinal location is considered a positive prognostic factor for other tumors of the CNS. While SFT/HPC of the CNS is known to frequently arise from the spinal meninges, there are no case series that report outcomes for spinally located CNS tumors, and their prognosis in relation to intracranial and other CNS-located tumors is unknown.

Objective

To investigate outcomes for patients with SFT/HPC of the spinal meninges.

Methods

The Surveillance, Epidemiology, and End-Results Program was used to identify patients with SFT/HPC within the CNS from 1993–2015. We retrospectively analyzed the relationship between tumor location (spinal vs. Brain and other CNS) and survival.

Results

We identified 551 cases of CNS SFT/HPC, 64 (11.6%) of which were primary tumors of the spinal meninges. Spinal tumors were more likely than brain and other CNS tumors to be SFT vs. HPC (37.5 vs. 12%, p < 0.001), benign (42.2 vs. 20.3%, p < 0.001), and less than 5 cm (53.1 vs. 35.7%, p < 0.001). The 10-year survival rates for spinal and brain/other CNS tumors were 85 and 58%, respectively. Median survival time was significantly longer for spinal tumors (median survival not reached vs. 138 months, p = 0.03, HR = 0.41 [95% CI 0.18–0.94]). On multivariable analysis, spinal tumor location was associated with improved survival over tumors located in the brain and other CNS (HR = 0.36 [95% CI 0.15–0.89], p = 0.03).

Conclusion

Spinal tumor location is associated with improved survival in patients with SFT/HPC of the CNS. Larger institutional studies are necessary to characterize the relationship between tumor location and other relevant factors such as presentation and amenability to gross-total resection and adjuvant radiotherapy. Future studies exploring optimal management of spinally located tumors are also needed.

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Funding

No outside funding was received to support this work.

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Author notes

  1. Deborah Boyett and Connor J. Kinslow indicates co-first authorship and equal contribution to the study

Authors and Affiliations

  1. Department of Neurological Surgery, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA

    Deborah Boyett, Guy M. McKhann, Michael B. Sisti & Jeffrey N. Bruce

  2. Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 622 West 168th Street, BNH B011, New York, NY, 10032, USA

    Connor J. Kinslow, Simon K. Cheng & Tony J. C. Wang

  3. Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 710 West 168th Street, New York, NY, 10032, USA

    Samuel S. Bruce

  4. Department of Neurosurgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL, 60611, USA

    Adam M. Sonabend

  5. Department of Neurological Surgery, Oregon Health & Sciences University, 3181 SW Sam Jackson Pkwy, Portland, OR, 97239, USA

    Ali I. Rae

  6. Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University Medical Center, 1130 St Nicholas Ave, New York, NY, 10032, USA

    Guy M. McKhann, Michael B. Sisti, Jeffrey N. Bruce, Simon K. Cheng & Tony J. C. Wang

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  1. Deborah Boyett
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Corresponding author

Correspondence to Tony J. C. Wang.

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Conflict of interest

Dr. Wang reports personal fees and non-financial support from AbbVie, non-financial support from Merck, personal fees from AstraZeneca, personal fees from Doximity, personal fees and non-financial support from Novocure, personal fees and non-financial support from Elekta and personal fees from Wolters Kluwer, outside the submitted work. All other authors report no financial conflicts of interest.

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Boyett, D., Kinslow, C.J., Bruce, S.S. et al. Spinal location is prognostic of survival for solitary-fibrous tumor/hemangiopericytoma of the central nervous system. J Neurooncol 143, 457–464 (2019). https://doi.org/10.1007/s11060-019-03177-0

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