Clinical Features, Management and Prognostic Factors of Intracranial Solitary Fibrous Tumor

2021 ◽  
Author(s):  
Jingdian Liu ◽  
Sisi Wu ◽  
Junwen Wang ◽  
Kai Shu ◽  
Ting Lei
Keyword(s):  
Prognostic Factors ◽  
Survival Rate ◽  
Clinical Features ◽  
Solitary Fibrous Tumor ◽  
Study Patient ◽  
Ki 67 ◽  
Who Grade ◽  
Female Ratio ◽  
Fibrous Tumor ◽  
Grade Iii

Abstract Purpose Due to low incidence and the constantly changing diagnostic and classification criteria, the clinical features, management and prognostic factors of intracranial solitary fibrous tumor (ISFT) remain unclear and were thus analyzed in this study. Methods A total of 38 patients who were diagnosed as ISFT in our institution were enrolled in this study. Patient data including age, gender, clinical presentation, histopathological features, immunohistochemistry staining, tumor location, tumor size, treatment methods, and prognosis were extracted and retrospectively analyzed. Results The median age at diagnosis was 45.5 years (range 28-66 years) and the male to female ratio was 1:1.53 in our series. The 3-, 5-, and 10-year progression-free survival rate was 82.2%, 62.8%, and 21.4%, respectively; and the 3-, 5-, and 10-year overall survival rate was 97.1%, 86.9% and 64.2%, respectively. Patients with high WHO grade (grade III) ISFTs had impaired PFS (p<0.05) and OS (p<0.01). Subtotal resection (STR) was associated with shorter PFS and OS (p<0.001, respectively). Postoperative radiotherapy (PORT) significantly improved PFS but not OS in patients with WHO grade III ISFTs (P=0.025). The PFS of patients with STR+PORT was improved compared with those who received STR alone, although not significant. Moreover, CD34-negative immunostaining and high Ki-67 index (>10%) were associated with impaired PFS in ISFTs.Conclusion Our study provides evidence that high tumor grade, subtotal tumor resection, CD34 negative immunostaining and high Ki-67 index (>10%) were independent predictors for poor prognosis of ISFTs. PORT should be recommended for patients with high grade ISFTs or STR.

scholarly journals Analysis of Prognostic Factors of World Health Organization Grade Ⅲ Meningiomas

2020 ◽  
Vol 10 ◽  
Author(s):  
Weidong Tian ◽  
Jingdian Liu ◽  
Kai Zhao ◽  
Junwen Wang ◽  
Wei Jiang ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Cox Regression ◽  
Postoperative Radiotherapy ◽  
World Health ◽  
Low Grade ◽  
Ki 67 ◽  
Who Grade ◽  
Who Grade Iii ◽  
Grade Iii

ObjectiveWHO grade III meningiomas are highly aggressive and lethal. However, there is a paucity of clinical information because of a low incidence rate, and little is known for prognostic factors. The aim of this work is to analyze clinical characteristics and prognosis in patients diagnosed as WHO grade III meningiomas.Methods36 patients with WHO grade III meningiomas were enrolled in this study. Data on gender, age, clinical presentation, preoperative Karnofsky Performance Status (KPS), histopathologic features, tumor size, location, radiologic findings, postoperative radiotherapy (RT), surgical treatment, and prognosis were retrospectively analyzed. Progression-free survival (PFS) and overall survival (OS) were evaluated using the Kaplan-Meier method. Univariate and multivariate analysis were conducted by the Cox regression model.ResultsMedian PFS is 20 months and median OS is 36 months in 36 patients with WHO grade III meningiomas. Patients with secondary tumors which transformed from low grade meningomas had lower PFS (p=0.0014) compared with primary group. Multivariate analysis revealed that tumors location (PFS, p=0.016; OS, p=0.013), Ki-67 index (PFS, p=0.004; OS, p&lt;0.001) and postoperative radiotherapy (PFS, p=0.006; OS, p&lt;0.001) were associated with prognosis.ConclusionWHO grade III meningiomas which progressed from low grade meningiomas were more prone to have recurrences or progression. Tumors location and Ki-67 index can be employed to predict patient outcomes. Adjuvant radiotherapy after surgery can significantly improve patient prognosis.

Basic FGF and Ki-67 proteins useful for immunohistological diagnostic evaluations in malignant solitary fibrous tumor

2003 ◽  
Vol 53 (5) ◽  
pp. 284-290 ◽  
Author(s):  
Yuliang Sun ◽  
Zenya Naito ◽  
Toshiyuki Ishiwata ◽  
Shotaro Maeda ◽  
Yuichi Sugisaki ◽  
...  
Keyword(s):  
Solitary Fibrous Tumor ◽  
Ki 67 ◽  
Basic Fgf ◽  
Fibrous Tumor

scholarly journals Solitary Fibrous Tumors of the Chest: An Analysis of Fifty Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Jingwen Zhang ◽  
Jumin Liu ◽  
Zhihao Zhang ◽  
Beizong Tian
Keyword(s):  
Solitary Fibrous Tumor ◽  
Chest Tightness ◽  
Ki 67 ◽  
Imaging Characteristics ◽  
Enhanced Ct ◽  
The Common ◽  
The Difference ◽  
Low Incidence ◽  
Fibrous Tumor

BackgroundA solitary fibrous tumor of the chest (SFTC) is a subtype of solitary fibrous tumor (SFT) with a low incidence rate. The purpose of this study is to analyze the diagnosis and treatment of SFTC and the difference between benign and malignant solitary fibrous tumor of the pleura (SFTP) to improve the understanding of this rare disease.MethodsA retrospective analysis of fifty patients with SFTC (33 cases in the pleura and 17 in the lung) was performed. Clinical and imaging characteristics, pathological features, and treatment follow-up outcomes were analyzed.ResultsThe common symptoms of the 50 patients included a cough, expectoration, chest tightness, fever, and chest pain. Space occupying lesions were found via plain computed tomography (CT) and enhanced CT was used for enhancement of the tumors. It was also found that 18 cases had necrosis, and 5 cases had calcification. The histopathology results showed that frequent nuclear division, obvious morphological variation, necrosis, and the high expression of Ki-67 cells are markers of malignant SFTC. There were significant differences in age, chest tightness, necrotic foci in CT, and expression of Ki-67 between the benign and malignant SFTP cases. All the patients who received treatment were given an excellent prognosis.ConclusionA combination of enhanced CT, histopathology, and immunohistochemistry can be used for the accurate diagnosis of SFTC. Advanced age, chest tightness, necrotic foci in CT, and a high Ki-67 index were more likely to be malignant SFTP. Operation and radiofrequency ablation can provide favorable outcomes for both benign and malignant SFTC.

scholarly journals EPID-09. PROGNOSTIC FACTORS IN ADULT PATIENTS WITH PRIMARY INTRACRANIAL EPENDYMOMAS: A POPULATION-BASED STUDY

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi76-vi76
Author(s):  
Helen Yang ◽  
Abdullah Malik ◽  
Sunit Das
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Health Care Professionals ◽  
Adult Patients ◽  
Age At Diagnosis ◽  
Who Grade ◽  
Intracranial Ependymoma ◽  
One Year ◽  
Who Grade Iii ◽  
Grade Iii

Abstract BACKGROUND Outcomes for patients with intracranial ependymoma remain poor in the current era of cancer treatment. This study aims to investigate the prognostic value of demographic and clinical variables to predict survival using the largest current database of patients with intracranial ependymoma. METHODS The Surveillance, Epidemiology and End Results (SEER) registry was queried for prognostic factors and survival outcomes of adult (≥18 years) patients diagnosed with intracranial ependymoma from 2004–2016. Survival was estimated using Kaplan Meier curves. Cox proportional hazards modeling was used to identify correlates of survival. RESULTS We identified a cohort of 229 primary intracranial ependymoma patients. The cohort showed a slight male predominance (52%) and had a mean age of 43 ± 17 years. 107 patients (47%) had WHO grade II tumors and 122 patients (53%) had WHO grade III tumors. One year survival was 85% for the entire cohort. Increasing age at diagnosis (HR: 1.05, 95% CI: 1.03–1.07) and WHO grade III tumor (HR: 4.20, 95% CI: 2.02–8.75) were independently associated with mortality after adjusting for age, sex, tumor location, extent of surgery, use of radiation therapy, and use of chemotherapy. Use of radiation therapy was associated with better one-year survival in cases of gross total resection (GTR) and subtotal resection (STR). Use of chemotherapy was not associated with mortality in the adjusted analysis (HR: 2.16, 95% CI: 0.96–4.84). CONCLUSION Our results suggest that age at diagnosis and tumor grade are independent factors associated with mortality in adult patients with intracranial ependymoma. Furthermore, use of chemotherapy was not shown to decrease mortality. These findings help guide future prognostic model making and therapeutic strategies designed by health care professionals.

scholarly journals Solitary Fibrous Tumor of the Kidney: A Case Report

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Abdullah Demirtaş ◽  
Volkan Sabur ◽  
Hülya Akgün ◽  
Emre Can Akınsal ◽  
Deniz Demirci
Keyword(s):  
Solitary Fibrous Tumor ◽  
Cystic Lesion ◽  
Spindle Cell ◽  
Left Kidney ◽  
Ki 67 ◽  
Spindle Cell Neoplasm ◽  
Cell Neoplasm ◽  
Fibrous Tumor ◽  
Immunohistochemical Studies ◽  
Hmb 45

Solitary fibrous tumor is a spindle cell neoplasm mostly originating from pleura; however, it has also recently been reported to be extrapleural. A 57-year-old man presented with left lumbal pain. Ultrasonography and computed tomography showed a cystic lesion of 14 × 11 cm with solid areas and septations in middle and lower poles of the left kidney. Radical nephrectomy was performed. Immunohistochemical studies showed strong reactions with CD34 and CD99. A nuclear positivity with Ki-67 was observed in less than 1% of cells. Despite repeated stainings with vimentin, no clear tumor evaluation could be made due to artifacts. The tumor was negative with Bcl-2, desmin, HMB-45, S100, FVIII, and CD31. Histopathological and molecular studies made the diagnosis of a solitary fibrous tumor. The patient is now currently free of disease at the 26th month of followup.

Prognostic factors of clear renal cell carcinoma in pT1a cases

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16064-e16064
Author(s):  
T. Nishikimi ◽  
T. Tsuzuki ◽  
T. Fujita ◽  
N. Sassa ◽  
H. Araki ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Cell Carcinoma ◽  
Distant Metastasis ◽  
Growth Pattern ◽  
Renal Cell ◽  
Vascular Invasion ◽  
Cell Renal Cell Carcinoma ◽  
Female Ratio

e16064 Background: The proportion of clear cell renal cell carcinoma (CRCC) cases diagnosed at pT1a is known to be increasing significantly. Although their prognosis is excellent in general, some cases show distant metastasis. Most of proposed prognostic factors are based on mainly large sized CRCC data. The prognostic factors for small sized CRCC, especially for pT1a cases, aren't well described. Methods: Three hundred three pT1a CRCC cases were retrieved from authors’ institution files. All cases were reviewed by the single uropathologist (T. Tsuzuki). For each case, the following pathological parameters were analyzed: patient age, tumor location (upper, middle, low), Furhman grade, presence of capsule, presence of lympho-vascular invasion, growth pattern (expansive or infiltrating), presence of scar, presence of hemorrhage, and presence of necrosis. Results: Male to female ratio was 4.4. Patient's age ranged from 21 to 85 years (median: 59 years). Follow up duration ranged from one to 225 months (median: 59 months). 35 cases showed distant metastasis. The 5-year and 10-year cause specific survival rate were 96.9%, 93.0%. The 5-year and 10-year recurrence free survival rate were 91.8%, 83.9%. Furhman grade (grade 1+2+3 vs. 4), presence of lympho-vascular invasion, infiltrating growth pattern, and presence of necrosis were statistical significant (p < 0.0001). Conclusions: Furhman grade (less than 3 vs. 4), presence of lympho-vascular invasion, growth pattern, and presence of necrosis can be prognostic factors in CRCC in pTa cases. Growth pattern, which is unrecognized concept for prognosis, can be a new prognostic factor in CRCC. No significant financial relationships to disclose.

scholarly journals The Value of 5-Aminolevulinic Acid in Low-grade Gliomas and High-grade Gliomas Lacking Glioblastoma Imaging Features: An Analysis Based on Fluorescence, Magnetic Resonance Imaging, 18F-Fluoroethyl Tyrosine Positron Emission Tomography, and Tumor Molecular Factors

Neurosurgery ◽  
2015 ◽  
Vol 78 (3) ◽  
pp. 401-411 ◽  
Author(s):  
Mohammed Jaber ◽  
Johannes Wölfer ◽  
Christian Ewelt ◽  
Markus Holling ◽  
Martin Hasselblatt ◽  
...  
Keyword(s):  
Aminolevulinic Acid ◽  
Methylation Status ◽  
Imaging Features ◽  
High Grade ◽  
Ki 67 ◽  
Who Grade ◽  
Fet Pet ◽  
Grade Ii ◽  
Grade Iii ◽  
Mib 1

Abstract BACKGROUND: Approximately 20% of grade II and most grade III gliomas fluoresce after 5-aminolevulinic acid (5-ALA) application. Conversely, approximately 30% of nonenhancing gliomas are actually high grade. OBJECTIVE: The aim of this study was to identify preoperative factors (ie, age, enhancement, 18F-fluoroethyl tyrosine positron emission tomography [18F-FET PET] uptake ratios) for predicting fluorescence in gliomas without typical glioblastomas imaging features and to determine whether fluorescence will allow prediction of tumor grade or molecular characteristics. METHODS: Patients harboring gliomas without typical glioblastoma imaging features were given 5-ALA. Fluorescence was recorded intraoperatively, and biopsy specimens collected from fluorescing tissue. World Health Organization (WHO) grade, Ki-67/MIB-1 index, IDH1 (R132H) mutation status, O6-methylguanine DNA methyltransferase (MGMT) promoter methylation status, and 1p/19q co-deletion status were assessed. Predictive factors for fluorescence were derived from preoperative magnetic resonance imaging and 18F-FET PET. Classification and regression tree analysis and receiver-operating-characteristic curves were generated for defining predictors. RESULTS: Of 166 tumors, 82 were diagnosed as WHO grade II, 76 as grade III, and 8 as glioblastomas grade IV. Contrast enhancement, tumor volume, and 18F-FET PET uptake ratio &gt;1.85 predicted fluorescence. Fluorescence correlated with WHO grade (P &lt; .001) and Ki-67/MIB-1 index (P &lt; .001), but not with MGMT promoter methylation status, IDH1 mutation status, or 1p19q co-deletion status. The Ki-67/MIB-1 index in fluorescing grade III gliomas was higher than in nonfluorescing tumors, whereas in fluorescing and nonfluorescing grade II tumors, no differences were noted. CONCLUSION: Age, tumor volume, and 18F-FET PET uptake are factors predicting 5-ALA-induced fluorescence in gliomas without typical glioblastoma imaging features. Fluorescence was associated with an increased Ki-67/MIB-1 index and high-grade pathology. Whether fluorescence in grade II gliomas identifies a subtype with worse prognosis remains to be determined.

scholarly journals Mitotic and Proliferative Indices in WHO Grade III Meningioma

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3351
Author(s):  
Andrea Daniela Maier ◽  
Christian Beltoft Brøchner ◽  
Jiri Bartek Jr. ◽  
Frank Eriksson ◽  
Heidi Ugleholdt ◽  
...  
Keyword(s):  
Mitotic Index ◽  
Hot Spot ◽  
Progression Free Survival ◽  
Ki 67 ◽  
Who Grade ◽  
Free Survival ◽  
Phosphohistone H3 ◽  
Proliferative Indices ◽  
Who Grade Iii ◽  
Grade Iii

Meningiomas with inherently high mitotic indices and poor prognosis, such as WHO grade III meningiomas, have not been investigated separately to establish interchangeability between conventional mitotic index counted on H&E stained slides (MI) and mitotic index counted on phosphohistone-H3 stained slides (PHH3 MI). This study investigates the agreement of MI and PHH3 MI and to analyze the association of progression-free survival (PFS) and MI, PHH3 MI, and the proliferative index (PI, Ki-67) in WHO grade III meningioma. Tumor specimens from 24 consecutive patients were analyzed for expression of Ki-67, PHH3 MI, and MI. Quantification was performed independently by two observers who made replicate counts in hot spots and overall tumor staining. Repeatability in replicate counts from MI and PHH3 MI was low in both observers. Consequently, we could not report the agreement. MI, PHH3 MI and hot spot counts of Ki-67 were associated with PFS (MI hot spot HR = 1.61, 95% CI 1.12–2.31, p = 0.010; PHH3 MI hot spot HR = 1.59, 95% CI 1.15–2.21, p = 0.006; Ki-67 hot spot HR = 1.06, 95% CI 1.02–1.11. p = 0.004). We found markedly low repeatability of manually counted MI and PHH3 MI in WHO grade III meningioma, and we could not conclude that the two methods agreed. Subsequently, quantification with better repeatability should be sought. All three biomarkers were associated with PFS.

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