Neurocytomas: Long-term experience of a single institution

Abstract

There is a lack of studies reporting on outcomes of control and treatment toxicities for neurocytomas. A 25-year retrospective review of a tertiary center's experience with neurocytomas was completed to report on these outcomes. All cerebral neurocytoma cases (19 patients; median age, 31 years; range, 18-62 years; 18 intraventricular and 1 extraventricular) treated between 1984 and 2009 were analyzed, including central pathology and radiology reviews. Median follow-up was 104.5 months (range, 0.75-261.7 months). Primary treatment was surgery alone (n = 18 patients), followed by surgery and adjuvant radiotherapy (n = 1). The crude local control rate after surgery was 68% for all cases (cerebral neurocytomas) and 74% for central neurocytomas. Salvage therapies included further surgery (n = 4), radiation (n = 3), and chemotherapy (n = 1). Ten-year Kaplan-Meier overall and relapse-free survival rates were 82% and 62% and 81% and 57%, respectively, for all cases and for central neurocytomas only. The median overall survival and relapse-free survival were 104.5 and 79.3 months, respectively, for all cases and for central neurocytomas. Ten patients had grade 3/4 toxicity, and 1 patient had a grade 5 perioperative hemorrhage that resulted in death 23 days after surgery. Late grade 3/4 toxicities occurred in 9 patients. Three patients had permanent grade 2 motor or cognitive deficits. We provide the first report outlining toxicities and survival outcomes in a series of 19 patients. Our experience suggests that initial surgery provides durable local control rates in two-thirds of patients, with low risk for significant permanent deficits. Salvage therapy with surgery and/or radiation provides durable local control in tumors that recur after surgery.

Operative management of intraventricular central neurocytomas: an analysis of a surgical experience with 32 cases

“…As CNs have a deep-seated intraventricular location, an abundant blood supply, and proximity to critical structures such as the fornix and thalamus, the surgical morbidity and mortality rates were relative high (6,8,(10)(11)(12)(13)(14)19,23). some reported rates of GTR ranged from 31% to 88%, mortality rates varied between 0% and 19%, and morbidity rates varied between 16% and 52% (Table IV).…”

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

“…Interestingly, in our series, greater extent of initial resection and smaller initial tumor size did not appear to correlate with improved local control. While most prior case series [18, 29, 32] assert that incomplete resection is associated with increased recurrence, this finding is inconsistent. A recent retrospective study of 45 central neurocytoma patients reported no significant difference in local control or survival between GTR and STR, but found local control and survival advantages in patients with lower mitotic indices [17].…”

“…Surgical resection is the primary treatment to establish pathologic diagnosis, to clear CSF pathways and to address any obstructive hydrocephalus [5]. Most studies support the idea that complete resection is an important predictor of recurrence [16, 18, 20, 21]; however, this fact remains unclear since other reports have not identified significant improvements in survival or local control [10, 17]. …”

Extraventricular neurocytoma in pediatric populations: A case report and review of the literature

“…Four patients exhibited features of histological atypia by pathological analysis, including necrosis and vascular hypertrophy. This indicated that in EVNs, the presence of a 1p19q codeletion, although rare, may imply aggressive clinical behavior and a poorer outcome (46). Mutation of the isocitrate dehydrogenase enzyme isoform 1 (IDH1 R132) and 2 (IDH2 R172) is associated with a large proportion of diffuse astrocytic and oligodendroglial tumors.…”