Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
Department of Neurologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
J Neurooncol. 2022 Aug;159(1):1-14. doi: 10.1007/s11060-022-03986-w. Epub 2022 Jun 25.
Sacral and presacral schwannomas are rare, accounting for a minority of spinal schwannomas. We present our institution's experience surgically treating spinal schwannomas and compare it to the literature.
Data were collected for 27 patients treated surgically for sacral or presacral schwannoma between 1997 and 2018 at all Mayo Clinic locations and 93 patients in the literature. Kaplan-Meier disease-free survival analysis was conducted. Unpaired two-sample t tests and Fisher's exact tests assessed statistical significance between groups.
Our patients and those in the literature experienced a similar age at diagnosis (49.9 y/o. vs 43.4 y/o., respectively). Most of our patients (59.3%) reported full recovery from symptoms, while a minority reported partial recovery (33.3%) and no recovery (11.1%). A smaller percentage in the literature experienced full recovery (31.9%) and partial recovery (29.8%) but also no recovery (1.1%). Our patients experienced fewer complications (14.8% versus 25.5%). Disease-free survival curves for all patients showed no significant variation in progression by extent of resection of schwannoma (log-rank P = 0.26). No lesion progression was associated with full or partial symptom improvement (p = 0.044), and female patients were more likely to undergo resection via a posterior approach (p = 0.042).
Outcomes of patients with sacral or presacral schwannomas vary based on patient demographics, tumor characteristics, symptoms, and surgical treatment. Among the range of symptoms experienced by these patients, the most common is pain. Prognosis improves and overall survival is high when the surgical approach towards sacral schwannomas is prepared and executed appropriately.
骶骨和骶前神经鞘瘤较为罕见，占所有脊髓神经鞘瘤的一小部分。我们介绍了本机构治疗骶骨和骶前神经鞘瘤的经验，并与文献进行了比较。
在 1997 年至 2018 年间，我们在梅奥诊所的所有分支机构收集了 27 例接受手术治疗的骶骨或骶前神经鞘瘤患者的数据，并与文献中的 93 例患者进行了比较。进行了 Kaplan-Meier 无病生存分析。使用独立样本 t 检验和 Fisher 确切检验评估组间的统计学意义。
我们的患者和文献中的患者在诊断时的年龄相似（分别为 49.9 岁和 43.4 岁）。我们的大多数患者（59.3%）报告症状完全缓解，少数患者报告部分缓解（33.3%）和无缓解（11.1%）。文献中的患者中，报告完全缓解（31.9%）和部分缓解（29.8%）的比例较小，但也有 1.1%的患者报告无缓解。我们的患者并发症发生率较低（14.8%与 25.5%）。所有患者的无病生存曲线显示，神经鞘瘤切除范围与肿瘤进展无显著差异（对数秩检验 P=0.26）。没有病变进展与完全或部分症状改善相关（p=0.044），并且女性患者更有可能通过后路进行切除（p=0.042）。
骶骨或骶前神经鞘瘤患者的治疗结果因患者的人口统计学特征、肿瘤特征、症状和手术治疗而异。在这些患者经历的一系列症状中，最常见的是疼痛。当适当准备和执行针对骶骨神经鞘瘤的手术方法时，患者的预后会改善，总体生存率较高。
