Solitary fibrous tumors of the central nervous system: clinicopathological and therapeutic considerations of 18 cases.
OBJECTIVE
This is a retrospective study of 18 patients harboring a solitary fibrous tumor of the central nervous system. Therapeutic management and outcome were analyzed.


METHODS
Between 1999 and 2004, 18 patients harboring central nervous system solitary fibrous tumors were surgically treated at our two institutions. There were nine men and nine women. The patient ages ranged from 33 to 75 years, with a median age of 56.1 years. The locations were spinal in six cases (33.3%), the posterior fossa in six cases (33.3%), supratentorial in four cases (22.2%), and orbital in two cases (11.2%).


RESULTS
The median follow-up period was 45.3 months. Gross total resection was achieved in 10 cases (55.6%); tumor recurrence or progression occurred in nine cases (50%). Incomplete surgical resection was significantly associated with recurrence (P = 0.018). On univariate analysis, extent of surgery was also associated with a longer progression-free survival (P = 0.05). No statistically significant correlation can be found between histological features and recurrence.


CONCLUSIONS
Prognosis of solitary fibrous tumors of the central nervous system remains unclear; consequently, careful and close monitoring of patients and long-term follow-up are mandatory. Radical surgical excision seems to be a significant and reliable prognosis factor, although pathological prognostic features must be defined. In other respects, the role of postoperative radiotherapy in atypical or incompletely resected solitary fibrous tumors of the central nervous system remains to be determined and, therefore, warrants larger series with longer follow-up periods.
Metellus
Philippe
P
Department of Neurosurgery, Hopital de La Timone, 13005 Marseille, France. philippe.metellus@mail.ap-hm.fr
Bouvier
Corinne
C
Guyotat
Jacques
J
Fuentes
Stéphane
S
Jouvet
Anne
A
Vasiljevic
Alexandre
A
Giorgi
Roch
R
Dufour
Henry
H
Grisoli
François
F
Figarella-Branger
Dominique
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018218:Neoplasms, Fibrous Tissue / Q000532:radiotherapy* / Q000601:surgery*; D013125:Spinal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D016896:Treatment Outcome