SOLITARY FIBROUS TUMOURS OF THE CENTRAL NERVOUS SYSTEM: CLINICOPATHOLOGICAL AND THERAPEUTIC ANALYSIS OF 14 CASES FROM A TERTIARY NEUROSURGICAL CENTRE

Abstract AIMS Solitary fibrous tumours (SFTs) are rare malignant mesenchymal neoplasms within the central nervous system (CNS). Although achieving surgical gross total resection (GTR) is a pivotal prognostic factor, the role and efficacy of postoperative radiotherapy (PORT) remain contentious. This study elucidates our institutional experience, placing particular emphasis on outcomes after PORT administration. METHODS Fourteen patients with CNS SFTs were studied through retrospective review of clinical presentation, radiologic findings, histopathologic characteristics, surgical intervention, adjuvant therapy, and prognosis. Kaplan-Meier survival analysis evaluated overall survival (OS) and recurrence-free survival (RFS) based on the world health organization (WHO) grade, extent of resection (EOR), and application of PORT. RESULTS The cohort included 8 men and 6 women. Magnetic resonance imaging (MRI) revealed slightly hyperintense lesions on T2-weighted images in all patients. All tumours showed positive immunohistochemical staining for signal transducer and activator of transcription 6. WHO grade III tumours had higher Ki-67 indices, stronger CD34 and BCL-2 staining, and more frequent RF positivity compared to WHO grade II tumours. Although grade III tumours exhibited poorer OS than grade II tumours, this was not statistically significant (p = 0.26). RFS was also not significantly different between grades II and III (p = 0.75), though grade III tumours showed earlier recurrences. GTR significantly improved OS compared to subtotal resection (STR) (p = 0.011), with STR patients experiencing a steeper decline in survival. While no significant difference in RFS was noted between GTR and STR (p = 0.45), STR was associated with earlier recurrences. Receiving PORT did not significantly improve OS (p= 0.19) or RFS (p = 0.45) compared to not receiving it. CONCLUSION Achieving complete tumour resection should be prioritised whenever feasible, with adjuvant radiotherapy ad- vised following surgical excision. Additionally, regular and long-term follow-up is imperative to monitor for potential recurrence.