Hemangiopericytoma: long-term outcome revisited. Clinical article

J Neurosurg. 2011 Mar;114(3):747-55. doi: 10.3171/2010.6.JNS091660. Epub 2010 Jul 30.


Object: Hemangiopericytomas are rare tumors that behave aggressively with a high rate of local recurrence and distant metastases. With the aim of determining the outcome and response to various treatment modalities, a series of 39 patients who underwent microsurgical resection for primary meningeal hemangiopericytoma over a 24-year period is presented.

Methods: Patients with hemangiopericytoma were identified from histopathology records and their medical records were analyzed retrospectively by 2 independent reviewers to collect data on surgical treatment, adjuvant therapy, postoperative course, local or distant recurrence, and follow-up.

Results: Of the 39 patients, 19 were male and 20 were female. Mean patient age was 44.1 years. Thirty-four tumors were intracranial and 5 were spinal. The mean follow-up period was 123 months. Twenty-eight patients developed local recurrence. The recurrence rate at 1, 5, and 15 years was 3.5%, 46%, and 92%, respectively. Extraneural metastasis occurred in 8 patients (26%) at an average of 123 months after initial surgery. Recurrences and metastases were treated by surgical excision, external beam radiation therapy (EBRT), chemotherapy, and/or stereotactic radiosurgery. Adjuvant EBRT following initial surgery was found to extend the disease-free interval from 154 months to 254 months, although it did not prevent the development of metastasis. In those patients with EBRT and complete resection, the mean recurrence-free interval was found to be 126.3 months longer (p = 0.04) and overall survival 126 months longer than without EBRT. Furthermore, adjusting for resection, patients undergoing EBRT had 0.33 times increased risk of recurrence compared with those who did not (p = 0.03). A majority of patients remained able to live independently despite revision surgery for recurrence.

Conclusions: The mean follow-up of this patient series represents the longest follow-up duration published to date and demonstrates extended survival in a significant number of patients with hemangiopericytoma. Gross-total resection followed by adjuvant EBRT provides patients with the highest probability of an increased recurrence-free interval and overall survival. Prolonged survival justifies long-term follow-up and aggressive treatment of initial, recurrent, and metastatic disease.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / surgery*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Hemangiopericytoma / drug therapy
  • Hemangiopericytoma / radiotherapy
  • Hemangiopericytoma / surgery*
  • Humans
  • Male
  • Meningeal Neoplasms / drug therapy
  • Meningeal Neoplasms / radiotherapy
  • Meningeal Neoplasms / surgery
  • Microsurgery / methods*
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neurosurgical Procedures / methods*
  • Prognosis
  • Radiosurgery
  • Survival Analysis
  • Treatment Outcome
  • Young Adult


  • Antineoplastic Agents