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

  • Deborah Boyett
  • Connor J. Kinslow
  • Samuel S. Bruce
  • Adam M. Sonabend
  • Ali I. Rae
  • Guy M. McKhann
  • Michael B. Sisti
  • Jeffrey N. Bruce
  • Simon K. Cheng
  • Tony J. C. WangEmail author
Clinical Study



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.


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


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.


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).


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.


Solitary-fibrous tumor Hemangiopericytoma Central nervous system Meningeal tumor Spinal tumor 



No outside funding was received to support this work.

Compliance with ethical standards

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.


  1. 1.
    Louis DN et al (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131(6):803–820Google Scholar
  2. 2.
    Robinson DR et al (2013) Identification of recurrent NAB2–STAT6 gene fusions in solitary fibrous tumor by integrative sequencing. Nat Genet 45(2):180–185Google Scholar
  3. 3.
    Chmielecki J et al (2013) Whole-exome sequencing identifies a recurrent NAB2–STAT6 fusion in solitary fibrous tumors. Nat Genet 45(2):131–132Google Scholar
  4. 4.
    Schweizer L et al (2013) Meningeal hemangiopericytoma and solitary fibrous tumors carry the NAB2–STAT6 fusion and can be diagnosed by nuclear expression of STAT6 protein. Acta Neuropathol 125(5):651–658Google Scholar
  5. 5.
    Macagno N et al (2016) Differential diagnosis of meningeal SFT-HPC and meningioma: which immunohistochemical markers should be used? Am J Surg Pathol 40(2):270–278Google Scholar
  6. 6.
    Fritchie KJ et al (2016) NAB2–STAT6 gene fusion in meningeal hemangiopericytoma and solitary fibrous tumor. J Neuropathol Exp Neurol 75(3):263–271Google Scholar
  7. 7.
    Bouvier C et al (2012) Solitary fibrous tumors and hemangiopericytomas of the meninges: overlapping pathological features and common prognostic factors suggest the same spectrum of tumors. Brain Pathol 22(4):511–521Google Scholar
  8. 8.
    Bisceglia M et al (2011) Solitary fibrous tumor of the central nervous system: a 15-year literature survey of 220 cases (August 1996–July 2011). Adv Anat Pathol 18(5):356–392Google Scholar
  9. 9.
    Tihan T et al (2003) Solitary fibrous tumors in the central nervous system A clinicopathologic review of 18 cases and comparison to meningeal hemangiopericytomas. Arch Pathol Lab Med. 127(4):432Google Scholar
  10. 10.
    Mena H et al (1991) Hemangiopericytoma of the central nervous system: a review of 94 cases. Hum Pathol 22(1):84–91Google Scholar
  11. 11.
    Kinslow CJ et al (2017) Invasiveness is associated with metastasis and decreased survival in hemangiopericytoma of the central nervous system. J Neurooncol 133(2):409–417Google Scholar
  12. 12.
    Guthrie BL et al (1989) Meningeal hemangiopericytoma: histopathological features, treatment, and long-term follow-up of 44 cases. Neurosurgery 25(4):514–522Google Scholar
  13. 13.
    Rutkowski MJ et al (2012) Intracranial hemangiopericytoma: clinical experience and treatment considerations in a modern series of 40 adult patients. Cancer 118(6):1628–1636Google Scholar
  14. 14.
    Kinslow CJ et al (2018) Solitary-fibrous tumor/hemangiopericytoma of the central nervous system: a population-based study. J Neurooncol 138(1):173–182Google Scholar
  15. 15.
    Trifiletti DM et al (2017) Clinical management and survival of patients with central nervous system hemangiopericytoma in the National Cancer Database. J Clin Neurosci 44:169–174Google Scholar
  16. 16.
    Darlix A et al (2017) Epidemiology for primary brain tumors: a nationwide population-based study. J Neurooncol 131(3):525–546Google Scholar
  17. 17.
    Zeng L et al (2017) Analyses of prognosis-related factors of intracranial solitary fibrous tumors and hemangiopericytomas help understand the relationship between the two sorts of tumors. J Neurooncol 131(1):153–161Google Scholar
  18. 18.
    Champeaux C et al (2017) Meningeal haemangiopericytoma and solitary fibrous tumour: a retrospective bi centre study for outcome and prognostic factor assessment. J Neurooncol 134(2):387–395Google Scholar
  19. 19.
    Champeaux C et al (2018) Solitary fibrous tumours and haemangiopericytoma of the meninges A retrospective study for outcome and prognostic factor assessment. Neurochirurgie. 64(1):37–43Google Scholar
  20. 20.
    Ghia AJ et al (2013) Intracranial hemangiopericytoma and the role of radiation therapy: a population based analysis. Neurosurgery 72(2):203–209Google Scholar
  21. 21.
    Stessin AM et al (2013) The role of postoperative radiation therapy in the treatment of meningeal hemangiopericytoma—experience from the SEER database. Int J Radiat Oncol Biol Phys 85(3):784–790Google Scholar
  22. 22.
    Sonabend AM et al (2014) The role for adjuvant radiotherapy in the treatment of hemangiopericytoma: a surveillance, epidemiology, and end results analysis. J Neurosurg 120(2):300–308Google Scholar
  23. 23.
    Hall WA et al (2012) Comparing central nervous system (CNS) and extra-CNS hemangiopericytomas in the Surveillance, Epidemiology, and End Results program: analysis of 655 patients and review of current literature. Cancer 118(21):5331–5338Google Scholar
  24. 24.
    Damodaran O et al (2014) Primary intracranial haemangiopericytoma: comparison of survival outcomes and metastatic potential in WHO grade II and III variants. J Clin Neurosci 21(8):1310–1314Google Scholar
  25. 25.
    Rutkowski MJ et al (2010) Predictors of mortality following treatment of intracranial hemangiopericytoma. J Neurosurg 113(2):333–339Google Scholar
  26. 26.
    Melone AG et al (2014) Intracranial hemangiopericytoma—our experience in 30 years: a series of 43 cases and review of the literature. World Neurosurg 81(3–4):556–562Google Scholar
  27. 27.
    Schiariti M et al (2011) Hemangiopericytoma: long-term outcome revisited clinical article. J Neurosurg 114(3):747–755Google Scholar
  28. 28.
    Kim JH et al (2003) Meningeal hemangiopericytomas: long-term outcome and biological behavior. Surg Neurol. 59(1):47–53 (discussion 53–4) Google Scholar
  29. 29.
    Seki T et al (2015) Surgical outcomes of high-grade spinal cord gliomas. Asian Spine J 9(6):935–941Google Scholar
  30. 30.
    Adams H et al (2012) Prognostic factors and survival in primary malignant astrocytomas of the spinal cord: a population-based analysis from 1973 to 2007. Spine (Phila Pa 1976) 37(12):E727–E735Google Scholar
  31. 31.
    Gezen F et al (2000) Review of 36 cases of spinal cord meningioma. Spine (Phila Pa 1976). 25(6):727–737Google Scholar
  32. 32.
    Bull JJ (1953) Spinal meningiomas and neurofibromas. Acta Radiol 40(2–3):283–300Google Scholar
  33. 33.
    Overview of the SEER Program. Accessed 19 Aug 2017
  34. 34.
    Davis FG, McCarthy BJ, Berger MS (1999) Centralized databases available for describing primary brain tumor incidence, survival, and treatment: central brain tumor registry of the united states; surveillance, epidemiology, and end results; and national cancer data base. Neuro Oncol 1(3):205–211Google Scholar
  35. 35.
    Zhou Z et al (2019) Clinical features, survival and prognostic factors of glycogen-rich clear cell carcinoma (GRCC) of the breast in the US population. J Clin Med 8:2Google Scholar
  36. 36.
    Rae AI et al (2018) Craniotomy and survival for primary central nervous system lymphoma. Neurosurgery. 1:nyy096Google Scholar
  37. 37.
    Surveillance, Epidemiology, and End Results (SEER) Program ( SEER*Stat Database: Incidence-SEER 9 Regs Research Data, Nov 2017 Sub (1973–2015) %3cKatrina/Rita Population Adjustment%3e—linked To County Attributes—Total U.S., 1969–2016 Counties. released April 2018, based on the November 2017 submission.
  38. 38.
    Louis DN et al (2007) The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 114(2):97–109Google Scholar
  39. 39.
    Facility oncology registry data standards (FORDS) (2013) Revised for 2013. Accessed 2018
  40. 40.
    Stessin AM et al (2013) The role of postoperative radiation therapy in the treatment of meningeal hemangiopericytoma—experience from the seer database. Int J Radiat Oncol Biol Phys. 85(3):784–790Google Scholar
  41. 41.
    Enzinger FM, Smith BH (1976) Hemangiopericytoma An analysis of 106 cases. Hum Pathol. 7(1):61–82Google Scholar
  42. 42.
    Chew LS et al (2017) Hemangiopericytoma of the thoracic spine: a case report. J Surg Case Rep. 2017(7):rjx121Google Scholar
  43. 43.
    Ecker RD et al (2003) Hemangiopericytoma in the central nervous system: treatment, pathological features, and long-term follow up in 38 patients. J Neurosurg 98(6):1182–1187Google Scholar
  44. 44.
    Cole CD, Schmidt MH (2009) Hemangiopericytomas of the spine: case report and review of the literature. Rare Tumors 1(2):e43Google Scholar
  45. 45.
    Jia Q et al (2018) Surgical management of spinal solitary fibrous tumor/hemangiopericytoma: a case series of 20 patients. Eur Spine J 27(4):891–901Google Scholar
  46. 46.
    Takenouchi T et al (2011) Solitary fibrous tumor with multiple intracranial and spinal lesions: case report. Neurosurgery 68(4):E1148–E1151Google Scholar
  47. 47.
    Ramakrishna R et al (2014) Hemangiopericytoma: radical resection remains the cornerstone of therapy. J Clin Neurosci 21(4):612–615Google Scholar
  48. 48.
    Kim YJ et al (2015) Treatment strategy of intracranial hemangiopericytoma. Brain Tumor Res Treat 3(2):68–74Google Scholar
  49. 49.
    Simpson D (1957) The recurrence of intracranial meningiomas after surgical treatment. J Neurol Neurosurg Psychiatry 20(1):22–39Google Scholar
  50. 50.
    Krieger N et al (1999) Social class, race/ethnicity, and incidence of breast, cervix, colon, lung, and prostate cancer among Asian, Black, Hispanic, and White residents of the San Francisco Bay Area, 1988–92 (United States). Cancer Causes Control 10(6):525–537Google Scholar
  51. 51.
    Clegg LX et al (2009) Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. Cancer Causes Control 20(4):417–435Google Scholar
  52. 52.
    Baquet CR et al (1991) Socioeconomic factors and cancer incidence among blacks and whites. J Natl Cancer Inst 83(8):551–557Google Scholar
  53. 53.
    Nilsson J et al (2018) The role of income in brain tumor patients: a descriptive register-based study: no correlation between patients' income and development of brain cancer. Med Oncol 35(4):52Google Scholar
  54. 54.
    Inskip PD et al (2003) Sociodemographic indicators and risk of brain tumours. Int J Epidemiol 32(2):225–233Google Scholar
  55. 55.
    Curry WT, Barker FG (2009) Racial, ethnic and socioeconomic disparities in the treatment of brain tumors. J Neurooncol. 93(1):25–39Google Scholar
  56. 56.
    McClelland S et al (2017) An overview of disparities research in access to radiation oncology care. 98(2):E11Google Scholar
  57. 57.
    Iwamoto FM et al (2008) Patterns of care in elderly glioblastoma patients. Ann Neurol 64(6):628–634Google Scholar
  58. 58.
    Sampson JH et al (2014) SEER insights. J Neurosurg 120(2):297–298Google Scholar
  59. 59.
    Merrill RM et al (2000) Cancer prevalence estimates based on tumour registry data in the Surveillance, Epidemiology, and End Results (SEER) Program. Int J Epidemiol 29(2):197–207Google Scholar
  60. 60.
    Yu JB et al (2009) NCI SEER public-use data: applications and limitations in oncology research. Oncology (Williston Park) 23(3):288–295Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Deborah Boyett
    • 1
  • Connor J. Kinslow
    • 2
  • Samuel S. Bruce
    • 3
  • Adam M. Sonabend
    • 4
  • Ali I. Rae
    • 5
  • Guy M. McKhann
    • 1
    • 6
  • Michael B. Sisti
    • 1
    • 6
  • Jeffrey N. Bruce
    • 1
    • 6
  • Simon K. Cheng
    • 2
    • 6
  • Tony J. C. Wang
    • 2
    • 6
    Email author
  1. 1.Department of Neurological Surgery, Vagelos College of Physicians and SurgeonsColumbia University Medical CenterNew YorkUSA
  2. 2.Department of Radiation Oncology, Vagelos College of Physicians and SurgeonsColumbia University Medical CenterNew YorkUSA
  3. 3.Department of Neurology, Vagelos College of Physicians and SurgeonsColumbia University Medical CenterNew YorkUSA
  4. 4.Department of NeurosurgeryNorthwestern University Feinberg School of MedicineChicagoUSA
  5. 5.Department of Neurological SurgeryOregon Health & Sciences UniversityPortlandUSA
  6. 6.Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and SurgeonsColumbia University Medical CenterNew YorkUSA

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