The importance of staged surgery for giant atypical central neurocytoma

Chaves, Jennyfer Paulla Galdino; Mattozo, Carlos Alberto; Telles, Bruno Augusto; Percicote, Ana Paula; Demartini, Zeferino; Maeda, Adriano Keijiro

doi:10.1007/s13760-020-01480-6

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…reported resection of a giant pediatric CN after successful preoperative embolization, which supposedly resulted in smaller blood loss. [ 7 ] The patients in our series did not receive preoperative embolization.…”

Section: Discussionmentioning

confidence: 99%

The last decade’s experience of management of central neurocytomas: Treatment strategies and new options

Konovalov

Maryashev

Pitskhelauri

et al. 2021

Surgical Neurology International

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Background: The purpose of the presented work is to evaluate the last decade’s experience in surgical management of central neurocytoma (CN) and elucidate on the treatment strategies and new options. Methods: The current series consists of the remaining 125 patients (70 females and 55 males) operated on during the past decade from 2008 to 2018. Most tumors were resected through transcortical (n = 76, 61%), or transcallosal (n = 40, 32%) approaches. In 5 (4%) patients with predominantly posterior location of the tumor, non-dominant superior parietal lobule approach was utilized. Both approaches (transcortical + transcallosal) were used in 4 (3%) of cases. Seven consecutive patients with large CN underwent prophylactic intraventricular stenting to prevent hydrocephalus. Results: Gross total resection was achieved in 45 patients (36%), subtotal resection (STR) in 40 (32%) cases. After surgery, 63 (50%) patients had neurocognitive problems, including disorientation, attention deficit, global amnesia, short-term memory deficits, and perceptual motor and social cognition problems. A total of 26 patients (21%) had postoperative hemorrhage in the resection bed. Obstructive hydrocephalus was noted in 25 (20%) patients. The entrapment of the occipital and/or temporal horns was observed in seven cases. None of the seven patients with prophylactic intraventricular stents required shunting. Conclusion: Although high rates of gross total or STR can be expected, the mortality and morbidity remain significant even in the modern neurosurgical era. Prophylactic intraventricular stenting in patients with large posteriorly located tumors with hydrocephalus may prevent ventricular entrapment and shunting. The main risk factors for recurrence are presence of residual disease and Ki-67 index over 5%. Recurrent symptomatic tumors should be treated surgically, whereas asymptomatic progression can be managed with stereotactic radiosurgery. Both treatment modalities are associated with low risk of complications and high tumor control rates.

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Section: Discussionmentioning

confidence: 99%

The last decade’s experience of management of central neurocytomas: Treatment strategies and new options

Konovalov

Maryashev

Pitskhelauri

et al. 2021

Surgical Neurology International

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“…Ma et al ( 24 ) suggested that the cavitronultrasonic-surgical-aspirator can be quite helpful to control blood loss during tumor resection. Chaves et al ( 27 ) raised that preoperative adjuvant embolization is a feasible strategy for the treatment of large CN. Some scholars believe that irrigation with saline after tumor resection is a useful way to remove the blood of the tumor cavity and make sure of satisfactory hemostasis ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome After Microsurgical Resection of Central Neurocytoma: A Single-Centre Analysis of 15 Years

et al. 2021

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Objective: This study aimed to explore the immediate postoperative and long-term outcomes of central neurocytoma (CN) based on 15 years of experience in our institution.Methods: This single-institution study collected data of 43 patients with CN who underwent surgery between 2005 and 2020. We reviewed data of clinical, immediate postoperative outcome, and long-term outcome of patients. More specifically, we divided complications into neurological and regional complications groups.Results: Among the 43 patients with CN who underwent surgery, the transcortical (72.1%) or transcallosal (25.6%) approach was used. There were 18 patients (41.9%) who complained about postoperative neurological complications, including motor weakness (25.6%), memory deficit (18.6%), aphasia (7.0%), and seizure (4.7%). In addition, 18 patients suffered postoperative regional complications such as hydrocephalus (2.3%), hematoma (34.9%), infection (4.7%), and subcutaneous hydrops (2.3%). Only one-quarter of patients had suffered permanent surgical complications. The majority of patients recovered from the deficit and could turn back to normal life. There were no significant differences in the clinical outcomes between transcortical and transcallosal approaches. At a median follow-up of 61.8 months, the 5-year overall survival and progression-free survival were 87.0 and 74.0%, respectively. A multivariate Cox model analysis showed that the extent of resection was not related to progression-free survival. However, the extent of resection was significantly associated with overall survival, and gross total resection decreased the risk of death.Conclusions: Patients with CN show favorable outcomes after surgery. The transcortical and transcallosal approaches have similar postoperative complication rates and long-term follow-up outcomes. In terms of long-term prognosis, maximal safety resection should be the first choice of CN.

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“…Finally, 7 papers were selected (Table 1) and included for further analysis. [14][15][16][17][18][19][20][21][22][23] Types of papers included 3 case series, 3 case reports, and 1 technical note (Table 1). The study publication dates ranged from 1998-2019.…”

Section: Database Searchmentioning

confidence: 99%

Staged Open Cranial Surgery for Primary Intra-axial Neoplasms: A Systematic Review

Bui¹,

Brown²,

Gendreau³

et al. 2023

Preprint

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Background Staged surgery for skull base lesions has been utilized to facilitate maximal safe resection and optimize outcomes while minimizing morbidity and complications. Conversely, staged surgery for primary intraparenchymal neoplasms is less commonly performed and has not been reported as extensively within the literature. As such, we performed a systematic review to examine the unique surgical indications for staging, timing between stages, specific surgical approaches employed, and postoperative complications of staged surgery for primary intra-axial neoplasms. Methods A literature search was conducted in August 2021 using PubMed, Web of Science, and Cochrane databases using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations. Titles and abstracts were evaluated independently by two authors, after which articles were selected for final analysis based on application of strict inclusion criteria during full text screen. Each included article was then qualitatively assessed and relevant variables – including operative approaches, timing, and outcomes – were extracted for synthesis. Results Of 115 results, 7 articles were included for final analysis and consisted of 17 pediatric and 4 adult patients. Staged approaches were more commonly utilized in the pediatric patient population for resection of astrocytoma and glioma. Pediatric patients had a timing of surgeries ranging from 5–10 days between operations, compared to 18 days-4 months in adult patients. Complications in pediatric patients were most commonly hemiparesis, hydrocephalus, CN VI and VII palsies, truncal ataxia, and cerebellar mutism, while complications in adult patients included language and abstract thinking deficits, respiratory failure, and motor weakness. Conclusion This study reports the first comprehensive review of staged surgical procedures for primary, intra-axial cranial neoplasms. There exists a large degree of heterogeneity in complications resulting from staged surgeries for intra-axial neoplasms, which are similar to complications associated with single-stage surgery for intraparenchymal lesions as well as multi-stage surgeries for skull base lesions.

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The importance of staged surgery for giant atypical central neurocytoma

Cited by 4 publications

References 12 publications

The last decade’s experience of management of central neurocytomas: Treatment strategies and new options

The last decade’s experience of management of central neurocytomas: Treatment strategies and new options

Clinical Outcome After Microsurgical Resection of Central Neurocytoma: A Single-Centre Analysis of 15 Years

Staged Open Cranial Surgery for Primary Intra-axial Neoplasms: A Systematic Review

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