Work

P09.12.a Outcomes in Solitary Fibrous Tumors With Multimodality Managment in a Specialised Neuro-oncology Practice in India

Year: 2025

Type: article

Abstract: BACKGROUND Solitary fibrous tumours (SFT) of the central nervous system (CNS), previously known as hemangiopericytomas (HPC), are rare mesenchymal neoplasms characterized by inversions at 12q13, fusing the NAB-2 and STAT-6 genes, leading to nuclear expression of STAT-6 and its consequent detection on immunohistochemistry. The World Health Organization classification defines three grades of SFT/HPC, with higher grade associated with worse outcomes. Maximal safe resection is the mainstay of treatment, and adjuvant radiotherapy (RT) is often added for high-grade or residual disease. However, due to the rarity of SFT, the impact of these factors on long-term outcomes remains unclear. MATERIAL AND METHODS We performed a retrospective review of all patients with CNS SFT treated at our centre from 2003-2020. Clinical characteristics, treatment details, and outcomes were collected from records. OS and PFS were estimated by Kaplan-Meier analysis, and associations of prognostic factors (tumour grade, extent of resection) with outcomes were evaluated using log-rank tests and Cox regression. A subgroup analysis on the basis of preceding literature was also done based on three risk groups: low risk (Grade 1, any extent of resection, or Grade 2 with gross total resection), intermediate risk (Grade 2 with biopsy or subtotal resection), and high risk (Grade 3, any extent of resection). RESULTS Eighty-two patients were included. The median age was 41 years, and 66% were male. Most tumours were intracranial (97.5%, largely supratentorial) and 93% were WHO grade II or III. Near Total Resection and Gross Total Resection was achieved in 45% and 38% patients respectively, and 75% of patients received postoperative RT (PORT). At a median follow-up of 48 months, 5-year PFS was 54% and 5-year OS was 89%. Neither tumour grade nor extent of resection significantly influenced PFS or OS. In subgroup analysis of 52 patients receiving PORT, no significant difference in outcomes was seen between intermediate- and high-risk groups. CONCLUSION Patients with CNS SFT/HPC treated with surgery and adjuvant therapy achieved favourable long-term outcomes in our series. PORT improves high-risk patient outcomes to levels comparable to intermediate-risk patients, supporting an aggressive multimodal approach. Further prospective studies are warranted.

Source: Neuro-Oncology

DOI: 10.1093/neuonc/noaf193.303