Objective: An intracranial solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm with a high predisposition toward recurrence and metastasis. The definition of SFT was updated according to the 2021 World Health Organization (WHO) classification. Given its rarity and resemblance to meningiomas, SFT is often misdiagnosed and there remains a debate on the treatment for it. We provide a retrospective analysis of SFTs and conclude the outcomes of different treatments.
Methods: Patients who accepted operation and were diagnosed with intracranial SFTs in our hospital were included between 2008 and 2021. The medical records on clinical characteristics and outcomes were summarized for analysis. Cox regressions were used to determine the hazard ratio (HR).
Results: Thirty-one SFT patients were included with a median follow-up time of 67 months. Tumor recurrence was observed in 12 (38.7%) patients, with 1 and 5-year recurrence rates of 6.5% and 22.6%, respectively. In univariate analysis, gross total resection (GTR) was significantly associated with decreased recurrence (P = 0.022), while subtotal resection (STR) (HR = 9.237; P = 0.020) and tumor location of tentorium (HR = 4.692; P = 0.022) were correlated with increased recurrence. In multivariate analysis, GTR (P = 0.040) and GTR plus radiotherapy (GTR + RT) (HR = 0.002; P = 0.020) were associated with reduced recurrence, while STR (HR = 40.835; P = 0.012) was a risk factor for recurrence.
Conclusions: GTR and postoperative RT are beneficial for preventing tumor recurrence. Larger studies and long-term follow-up are warranted to further identify the effect of postoperative RT.
Keywords: Central nervous system; Gross total resection; Radiotherapy; Recurrence; Solitary fibrous tumor.
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