Clinical characteristics and prognostic analysis of recurrent hemangiopericytoma in the central nervous system: a review of 46 cases.

Central nervous system hemangiopericytoma (HPC) is a malignant vascularized mesenchymal tumor with a high rate of recurrence. Because of its rarity, few clinical characteristics and prognostic analysis information regarding recurrent HPC exist for doctors to pursue optimal outcomes. Forty-six recurrent HPC cases treated at our hospital between 2004 and 2012 were compiled into a single database based on a retrospective review of patient records, which were used to summarize the clinical characteristics. The mean survival of the recurrent HPC patients in our cohort was 41.6 ± 4.4 months, with 1-, 2-, 3-, and 4-year survival rates of 80.4, 65.2, 59.2, and 53.8 %, respectively. Thirty patients (65.2 %) suffered their first tumor recurrence, with a mean survival of 36.9 ± 4.1 months. Sixteen patients (34.8 %) suffered a second or further tumor recurrence, with a mean survival of 39.7 ± 7.0 months. Eighteen patients (39.1 %) died of all causes during the follow-up period, with a mean survival of 14.2 ± 5.6 months. Univariate and multivariate regression analyses showed that factors associated with good prognosis included recurrence age over 35 years, an interval between the first and second recurrence of more than 1 year and a clear boundary of the recurrent tumor. Gross total resection with adjuvant external beam radiotherapy could independently delay tumor recurrence of the second or more times and prolong the postoperative survival; thus, this strategy should be pursued as the initial treatment.