Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Department of Neurosurgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
World Neurosurg. 2018 Jan;109:e59-e66. doi: 10.1016/j.wneu.2017.09.103. Epub 2017 Sep 25.
Central neurocytoma (CN) is a rare central nervous system tumor the optimal management strategy of which remains controversial because of their rarity. Detailed information on CN is necessary to establish optimal management strategies. The purpose of this study was to show the clinical features, treatments, and long-term clinical outcomes of CN.
A total of 63 patients with CN were surgically treated between 1995 and 2016 at West China Hospital. All pathologically proven CN cases were identified. Epidemiologic characteristics, clinical features, imaging features, functional outcomes, overall survival, and progression-free survival according to multimodal treatments were reviewed retrospectively.
There were 29 males and 34 females, with a median age of 29 years (range, 15-58 years). Thirty-four patients underwent gross total resection (GTR) and 29 patients underwent subtotal resection (STR). The surgical approaches to CNs in this study included a transcortical approach (39 cases) and an interhemispheric transcallosal approach (24 cases). There were no differences in functional outcomes or initial extent of resection according to the surgical approach used. The extent of resection was GTR in 34 patients (54.0%), and STR in 29 patients (46.0%). At the median follow-up of 74 months (range, 6-205 months), the actuarial 5-year and 10-year overall survival were 93.3% and 85.4%. At the last follow-up, 8 patients had experienced tumor progression. The 5-year and 10-year progression-free rate was 73.4% and 57.5%. The initial extent of resection and multimodal treatment was not related to overall survival; however, the actuarial local control rate differed significantly according to the initial extent of resection and multimodal treatment.
CN is a rare type of World Health Organization grade II primary brain tumor with a tendency to recur. Complete resection of CNs with maximal safety remains the primary treatment to minimize local progression. Adjuvant radiotherapy should be considered in patients receiving incomplete resection. The long-term clinical outcomes of CN after multimodal treatment seem to be satisfactory.
中枢神经细胞瘤（CN）是一种罕见的中枢神经系统肿瘤，由于其罕见性，其最佳治疗策略仍存在争议。详细了解 CN 对于制定最佳治疗策略是必要的。本研究旨在展示 CN 的临床特征、治疗方法和长期临床结果。
2016 年在华西医院对 63 例经手术治疗的 CN 患者进行了回顾性研究。所有经病理证实的 CN 病例均被识别。回顾性分析了流行病学特征、临床特征、影像学特征、功能结局、总生存和根据多模态治疗的无进展生存情况。
患者中男 29 例，女 34 例，中位年龄 29 岁（范围 15-58 岁）。34 例行肿瘤全切除（GTR），29 例行次全切除（STR）。本研究中 CN 的手术入路包括经皮质入路（39 例）和胼胝体间入路（24 例）。手术入路与功能结局或初始切除范围无差异。34 例（54.0%）患者行 GTR，29 例（46.0%）患者行 STR。中位随访 74 个月（范围 6-205 个月）时，患者的 5 年和 10 年总生存率分别为 93.3%和 85.4%。末次随访时，8 例患者出现肿瘤进展。5 年和 10 年无进展生存率分别为 73.4%和 57.5%。初始切除范围和多模态治疗与总生存率无关；然而，根据初始切除范围和多模态治疗，局部控制率有显著差异。
CN 是一种罕见的二级原发性脑肿瘤，具有复发倾向。最大限度地安全切除 CN 仍然是减少局部进展的主要治疗方法。对于不完全切除的患者，应考虑辅助放疗。CN 经多模态治疗后的长期临床结果似乎令人满意。
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