Surgical Management and Adverse Factors for Recurrence and Long-Term Survival in Patients with Hemangiopericytoma

OBJECTIVE: Intracranial hemangiopericytoma is a rare tumor with high recurrence rate. We analyzed adverse factors for recurrence and survival of patients with hemangiopericytoma. METHODS: We retrospectively reviewed clinical data of 120 patients (mean age, 42 years; 60 male patients) with hemangiopericytoma who were surgically treated in our hospital from December 2008 to January 2016. RESULTS: Gross total resection (GTR) rate was 71.7%. Postoperative adjuvant radiotherapy (PRT) was administered to 63 patients. After median follow-upperiod of 46.9 months, 35 (29.1%) recurrences and 17 (14.1%) deaths were observed. Progression-free survival (PFS) at 1, 3, and 5 years was 90.8%, 78.5%, and 68.0%, and corresponding overall survival rate was 99.2%, 93.7%, and 82.4%. Higher preoperative Karnofsky performance scale scores (hazard ratio [HR] [0.896, 95% confidence interval [CI] [0.845-0.950, p< 0.001), convex surface location (HR=2.151, 95% CI [1.042e4.443, p=0.038), and PRT (HR=0.339, 95% CI=0.159e0.724, p[ 0.005) were independent favorable factors for PFS. For overall survival, higher preoperative Karnofsky performance scale scores (HR=0.914, 95% CI=0.854-0.978, P=0.009), GTR (HR=0.291, 95% CI=0.109-0.777, P=0.014), and PRT (HR=0.210, 95% CI [0.060e0.734, p=0.015) were independent favorable factors. In patients undergoing nonGTR, PRT significantly improved PFS (HR=0.252, 95% CI=0.070-0.906, p[0.035). CONCLUSIONS: This study revealed risk factors for PFS and overall survival to predict outcomes and determine treatments. GTR was attempted as frequently as possible, and PRT was recommended for patients with non-GTR or recurrence to improve tumor control.