Assessment of care pattern and outcome in hemangioblastoma

Sci Rep. 2018 Jul 24;8(1):11144. doi: 10.1038/s41598-018-29047-9.

Abstract

Due to its rarity, current literature assessing prognostic factors and survival outcomes of hemangioblastoma is limited. Patients with histologically confirmed hemangioblastoma were identified from the US National Cancer Data Base. 1488 patients met inclusion criteria. 644 patients underwent gross total resection (GTR), 220 subtotal resection (STR)/biopsy, 60 stereotactic radiosurgery (SRS), 15 external beam radiotherapy (EBRT), 51 surgery followed by radiotherapy (SR + RT) and 498 no treatment. Independent predictors of shorter OS included age ≥ 40 (HR, 3.897; 95% CI, 2.341-6.487; p < 0.001), Charlson-Deyo score ≥ 1(HR, 1.756; 95% CI, 1.213-2.544; p = 0.003), tumor location in the brainstem (HR, 1.955; 95% CI, 1.129-3. 384; p = 0.017) compared to cerebellum, no treatment (HR, 2530; 95% CI, 1.533-4.177; p < 0.001) and receipt of EBRT (HR, 2.860; 95% CI, 1.073-7.618; p = 0.036) compared to STR/biopsy. GTR was associated with longer OS (HR 0.617; 95% CI, 0.391-0.974; p = 0.038), while SRS had comparable OS to STR/biopsy. The overall trend of OS by treatment modality was consistent after matching to age- and sex-matched US population data. In patients younger than 40 years, treatment was not a significant predictor of OS. In conclusion, GTR remained the optimal treatment for hemangioblastoma. SRS may perform similarly to surgery alone. Treatment was not a significant predictor of survival in younger patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Cerebellar Neoplasms / mortality*
  • Cerebellar Neoplasms / pathology
  • Cerebellar Neoplasms / therapy*
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hemangioblastoma / mortality*
  • Hemangioblastoma / pathology
  • Hemangioblastoma / therapy*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome and Process Assessment, Health Care / methods*
  • Prognosis
  • Proportional Hazards Models
  • Radiosurgery
  • Radiotherapy, Adjuvant
  • Survival Rate
  • Treatment Outcome
  • Young Adult