| Hemangiopericytoma: long-term outcome revisited. | |
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MedLine Citation:
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PMID: 20672899 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Object Hemangiopericytomas are rare tumors that behave aggressively with a high rate of local recurrence and distant metastases. With the aim of determining the outcome and response to various treatment modalities, a series of 39 patients who underwent microsurgical resection for primary meningeal hemangiopericytoma over a 24-year period is presented. Methods Patients with hemangiopericytoma were identified from histopathology records and their medical records were analyzed retrospectively by 2 independent reviewers to collect data on surgical treatment, adjuvant therapy, postoperative course, local or distant recurrence, and follow-up. Results Of the 39 patients, 19 were male and 20 were female. Mean patient age was 44.1 years. Thirty-four tumors were intracranial and 5 were spinal. The mean follow-up period was 123 months. Twenty-eight patients developed local recurrence. The recurrence rate at 1, 5, and 15 years was 3.5%, 46%, and 92%, respectively. Extraneural metastasis occurred in 8 patients (26%) at an average of 123 months after initial surgery. Recurrences and metastases were treated by surgical excision, external beam radiation therapy (EBRT), chemotherapy, and/or stereotactic radiosurgery. Adjuvant EBRT following initial surgery was found to extend the disease-free interval from 154 months to 254 months, although it did not prevent the development of metastasis. In those patients with EBRT and complete resection, the mean recurrence-free interval was found to be 126.3 months longer (p = 0.04) and overall survival 126 months longer than without EBRT. Furthermore, adjusting for resection, patients undergoing EBRT had 0.33 times increased risk of recurrence compared with those who did not (p = 0.03). A majority of patients remained able to live independently despite revision surgery for recurrence. Conclusions The mean follow-up of this patient series represents the longest follow-up duration published to date and demonstrates extended survival in a significant number of patients with hemangiopericytoma. Gross-total resection followed by adjuvant EBRT provides patients with the highest probability of an increased recurrence-free interval and overall survival. Prolonged survival justifies long-term follow-up and aggressive treatment of initial, recurrent, and metastatic disease. |
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Authors:
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Marco Schiariti; Pablo Goetz; Hussien El-Maghraby; Jignesh Tailor; Neil Kitchen |
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Publication Detail:
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Type: Journal Article Date: 2010-07-30 |
Journal Detail:
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Title: Journal of neurosurgery Volume: 114 ISSN: 1933-0693 ISO Abbreviation: J. Neurosurg. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 747-55 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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