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Clinical outcome and prognostic factors for central neurocytoma: twenty year institutional experience.

Abstract：

:Central neurocytomas are uncommon intraventricular neoplasms whose optimal management remains controversial due to their rarity. We assessed outcomes for a historical cohort of neurocytoma patients and evaluated effects of tumor atypia, size, resection extent, and adjuvant radiotherapy. Progression-free survival (PFS) was measured by Kaplan-Meier and Cox proportional hazards methods. A total of 28 patients (15 males, 13 females) were treated between 1995 and 2014, with a median age at diagnosis of 26 years (range 5-61). Median follow-up was 62.2 months and 3 patients were lost to follow-up postoperatively. Thirteen patients experienced recurrent/progressive disease and 2-year PFS was 75% (95% CI 53-88%). Two-year PFS was 48% for MIB-1 labeling >4% versus 90% for ≤4% (HR 5.4, CI 2.2-27.8, p = 0.0026). Nine patients (32%) had gross total resections (GTR) and 19 (68%) had subtotal resections (STR). PFS for >80% resection was 83 versus 67% for ≤80% resection (HR 0.67, CI 0.23-2.0, p = 0.47). Three STR patients (16%) received adjuvant radiation which significantly improved overall PFS (p = 0.049). Estimated 5-year PFS was 67% for STR with radiotherapy versus 53% for STR without radiotherapy. Salvage therapy regimens were diverse and resulted in stable disease for 54% of patients and additional progression for 38 %. Two patients with neuropathology-confirmed atypical neurocytomas died at 4.3 and 113.4 months after initial surgery. For central neurocytomas, MIB-1 labeling index >4% is predictive of poorer outcome and our data suggest that adjuvant radiotherapy after STR may improve PFS. Most patients requiring salvage therapy will be stabilized and multiple modalities can be effectively utilized.

journal_name

J Neurooncol

journal_title

Journal of neuro-oncology

authors

Imber BS,Braunstein SE,Wu FY,Nabavizadeh N,Boehling N,Weinberg VK,Tihan T,Barnes M,Mueller S,Butowski NA,Clarke JL,Chang SM,McDermott MM,Prados MD,Berger MS,Haas-Kogan DA

doi

10.1007/s11060-015-1959-y

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

193-200

issue

eissn

0167-594X

issn

1573-7373

pii

10.1007/s11060-015-1959-y

journal_volume

126

pub_type

杂志文章

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Clinical outcome and prognostic factors for central neurocytoma: twenty year institutional experience.