Long-Term Outcomes of Central Nervous System Solitary Fibrous Tumors: A Single-Institution Experience

Background: Central nervous system (CNS) solitary fibrous tumors (SFTs) are rare neoplasms with limited outcome data. We describe our institutional experience with adult CNS SFTs. Methods: We retrospectively reviewed adults (≥18 years) with histopathologically confirmed CNS SFTs treated at a tertiary referral center between 2005 and 2023. Clinical, radiologic, pathologic, treatment, and follow-up data were collected from the electronic medical record, and pathology was centrally reviewed. Results: Twelve patients were included. Median age at diagnosis was 38 years (range, 18–52), and 58.3% were male. The cohort included 11 intracranial tumors and 1 primary spinal tumor. WHO Grade 3 tumors were most common (n = 6, 50%). Initial treatment with subtotal resection was performed in six patients (50%), gross total resection in five (41.7%), and biopsy alone in one (8.3%). Adjuvant radiotherapy was administered in 58.3% (n = 7), and chemotherapy in one of the two patients with extracranial relapse. Six patients (50%) developed local recurrence, and two (16.7%) experienced extracranial relapse. Five- and ten-year overall survival rates were both 91.7%, and five- and ten-year recurrence-free survival rates were 73.3% and 50.3%, respectively. With a median follow-up of 12 years, late events included extracranial metastases at 8.9 and 9.4 years, and local recurrences at 11.1 and 17.2 years. Conclusions: CNS SFTs in adults show frequent local relapse and disease events more than a decade after treatment. Prolonged surveillance is warranted, and larger multicenter studies are needed to define prognostic factors and optimal treatment.