Neuropathic Pain Following Surgery for Malignant Peripheral Nerve Sheath Tumors.

BACKGROUND

Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive soft tissue sarcomas that pose significant challenges in surgical management. This study aims to examine the anatomic distribution of MPNSTs, analyze survival rates and predictive factors for survival, and investigate the prevalence of neuropathic pain in patients who have undergone MPNST resection.

PATIENTS AND METHODS

A retrospective analysis of 119 patients who underwent MPNST resection was conducted. Additionally, a cross-sectional survey was administered and completed by 39 surviving patients to assess neuropathic pain prevalence using the NRS (0-10 scale) and the s-DN4 questionnaire, and quality of life (QoL) using the EQ-5D-5L index (0-1 scale).

RESULTS

MPNSTs most commonly occurred in the lower extremity (42.9%), followed by the upper extremity (21.0%), trunk (19.3%), head and neck (11.8%), and pelvis (5.0%). Female sex (OR: 0.25, 95% CI: 0.10-0.61) and absence of metastases (OR: 0.15, 95% CI: 0.05-0.52) were significantly associated with lower odds of mortality. Among survey respondents, 82.1% reported neuropathic pain following MPNST resection. The patients reported a mean EQ-5D-5L index score of 0.566 (± 0.253) as compared with an EQ-5D-5L of 0.851 (± 0.205) for the US general population.

CONCLUSIONS

The high prevalence of neuropathic pain following MPNST resection and its significant impact on QoL highlights the need for improved pain management strategies. Nerve-sparing and/or nerve-reconstructive techniques during or after tumor resection should be considered. Future research should focus on identifying risk factors for neuropathic pain development and evaluating the efficacy of preventive measures to improve long-term pain outcomes for surviving patients with MPNST.