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Impact of extent of resection and postoperative radiotherapy on survival outcomes in intracranial solitary fibrous tumors: a systematic review and meta-analysis

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Abstract

The knowledge of optimal treatments for patients with intracranial solitary fibrous tumor (SFT) is limited, with inconclusive results from previous studies. In this study, we conducted a meta-analysis of relevant studies to identify the prognostic impact of the extent of resection (EOR) and postoperative radiotherapy (PORT) on survival outcomes of patients with intracranial SFT. We searched the Medline, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify relevant studies published till April 2022. Progression-free survival (PFS) and overall survival (OS) were the outcomes of interest. Differences between two cohorts (gross total resection [GTR] vs. subtotal resection [STR] and PORT vs. surgery only) were estimated by calculating hazard ratios. Twenty-seven studies were selected for the meta-analysis, including data of 1348 patients (GTR, n = 819 vs. STR, n = 381 and PORT, n = 723 vs. surgery only, n = 578). Pooled hazard ratios of PFS (1, 3, 5, and 10 years) and OS (3, 5, and 10 years) revealed that the GTR cohort showed sustained superiority over the STR cohort. In addition, the PORT cohort was superior to the surgery-only cohort with respect to all PFS periods. Although the 10-year OS between the two cohorts was not statistically different, PORT showed significantly better 3- and 5-year OS than surgery only. The study findings suggest that GTR and PORT provide significant benefits for PFS and OS. Aggressive surgical resection of tumors to achieve GTR followed by PORT should be implemented as optimal treatments for all patients with intracranial SFT when feasible.

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Data availability

The datasets generated or analyzed during the study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No. 2020R1G1A1013289).

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  1. Sae Min Kwon and Min Kyun Na contributed equally to this work and are co-first authors.

Authors and Affiliations

  1. Department of Neurosurgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea

    Sae Min Kwon

  2. Department of Neurosurgery, College of Medicine, Hanyang University, Seoul, Korea

    Min Kyun Na & Kyu-Sun Choi

  3. Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Korea

    Tae Ho Lim, Hyungoo Shin, Juncheol Lee & Heekyung Lee

  4. Department of Emergency Medicine, College of Medicine, Hallym University, Chuncheon, Korea

    Wonhee Kim, Youngsuk Cho & Jae Guk Kim

  5. Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Korea

    Chiwon Ahn

  6. Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, Republic of Korea, 02447

    Bo-Hyoung Jang

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Sae Min Kwon, Min Kyun Na, and Bo-Hyoung Jang. The first draft of the manuscript was written by Sae Min Kwon and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Bo-Hyoung Jang.

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This review was performed in compliance with the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [1]. Since this study did not infringe on the patients’ personal information or rights, ethical approval was not necessary.

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Kwon, S.M., Na, M.K., Choi, KS. et al. Impact of extent of resection and postoperative radiotherapy on survival outcomes in intracranial solitary fibrous tumors: a systematic review and meta-analysis. Neurosurg Rev 46, 138 (2023). https://doi.org/10.1007/s10143-023-02046-9

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