Abstract
Central neurocytomas are uncommon intraventricular neoplasms whose optimal management remains controversial due to their rarity. We assessed outcomes for a historical cohort of neurocytoma patients and evaluated effects of tumor atypia, size, resection extent, and adjuvant radiotherapy. Progression-free survival (PFS) was measured by Kaplan–Meier and Cox proportional hazards methods. A total of 28 patients (15 males, 13 females) were treated between 1995 and 2014, with a median age at diagnosis of 26 years (range 5–61). Median follow-up was 62.2 months and 3 patients were lost to follow-up postoperatively. Thirteen patients experienced recurrent/progressive disease and 2-year PFS was 75 % (95 % CI 53–88 %). Two-year PFS was 48 % for MIB-1 labeling >4 % versus 90 % for ≤4 % (HR 5.4, CI 2.2–27.8, p = 0.0026). Nine patients (32 %) had gross total resections (GTR) and 19 (68 %) had subtotal resections (STR). PFS for >80 % resection was 83 versus 67 % for ≤80 % resection (HR 0.67, CI 0.23–2.0, p = 0.47). Three STR patients (16 %) received adjuvant radiation which significantly improved overall PFS (p = 0.049). Estimated 5-year PFS was 67 % for STR with radiotherapy versus 53 % for STR without radiotherapy. Salvage therapy regimens were diverse and resulted in stable disease for 54 % of patients and additional progression for 38 %. Two patients with neuropathology-confirmed atypical neurocytomas died at 4.3 and 113.4 months after initial surgery. For central neurocytomas, MIB-1 labeling index >4 % is predictive of poorer outcome and our data suggest that adjuvant radiotherapy after STR may improve PFS. Most patients requiring salvage therapy will be stabilized and multiple modalities can be effectively utilized.
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References
Hassoun J, Gambarelli D, Grisoli F, Pellet W, Salamon G, Pellissier JF, Toga M (1982) Central neurocytoma. An electron-microscopic study of two cases. Acta Neuropathol (Berl) 56:151–156
Mozes P, Szanto E, Tiszlavicz L, Barzo P, Cserhati A, Fodor E, Hideghety K (2013) Clinical Course of Central Neurocytoma with Malignant Transformation-An Indication for Craniospinal Irradiation. Pathol Oncol Res POR
Hassoun J, Söylemezoglu F, Gambarelli D, Figarella-Branger D, von Ammon K, Kleihues P (1993) Central neurocytoma: a synopsis of clinical and histological features. Brain Pathol Zurich Switz 3:297–306
Sharma MC, Deb P, Sharma S, Sarkar C (2006) Neurocytoma: a comprehensive review. Neurosurg Rev 29:270–285
Schmidt MH, Gottfried ON, von Koch CS, Chang SM, McDermott MW (2004) Central neurocytoma: a review. J Neurooncol 66:377–384
Zhang D, Wen L, Henning TD, Feng X-Y, Zhang Y-L, Zou L-G, Zhang Z-G (2006) Central neurocytoma: clinical, pathological and neuroradiological findings. Clin Radiol 61:348–357
Smith AB, Smirniotopoulos JG, Horkanyne-Szakaly I (2013) From the Radiologic Pathology Archives: Intraventricular Neoplasms: Radiologic-Pathologic Correlation. RadioGraphics 33:21–43
Wang M, Jia D, Shen J, Zhang J, Li G (2013) Clinical and imaging features of central neurocytomas. J Clin Neurosci Off J Neurosurg Soc Australas 20:679–685
Christov C, Adle-Biassette H, Le Guerinel C (1999) Recurrent central neurocytoma with marked increase in MIB-1 labelling index. Br J Neurosurg 13:496–499
Garcia RM, Ivan ME, Oh T, Barani I, Parsa AT (2014) Intraventricular neurocytomas: a systematic review of stereotactic radiosurgery and fractionated conventional radiotherapy for residual or recurrent tumors. Clin Neurol Neurosurg 117:55–64
Söylemezoglu F, Scheithauer BW, Esteve J, Kleihues P (1997) Atypical central neurocytoma. J Neuropathol Exp Neurol 56:551–556
Sharma MC, Rathore A, Karak AK, Sarkar C (1998) A study of proliferative markers in central neurocytoma. Pathology (Phila) 30:355–359
Mackenzie IR (1999) Central neurocytoma: histologic atypia, proliferation potential, and clinical outcome. Cancer 85:1606–1610
Genc A, Bozkurt SU, Karabagli P, Seker A, Bayri Y, Konya D, Kilic T (2011) Gamma knife radiosurgery for cranial neurocytomas. J Neurooncol 105:647–657
Rades D, Schild SE, Fehlauer F (2004) Prognostic value of the MIB-1 labeling index for central neurocytomas. Neurology 62:987–989
Kaur G, Kane AJ, Sughrue ME, Oh M, Safaee M, Sun M, Tihan T, McDermott MW, Berger MS, Parsa AT (2013) MIB-1 labeling index predicts recurrence in intraventricular central neurocytomas. J Clin Neurosci Off J Neurosurg Soc Australas 20:89–93
Leenstra JL, Rodriguez FJ, Frechette CM et al (2007) Central neurocytoma: management recommendations based on a 35-year experience. Int J Radiat Oncol Biol Phys 67:1145–1154
Hallock A, Hamilton B, Ang LC, Tay KY, Meygesi JF, Fisher BJ, Watling CJ, Macdonald DR, Bauman GS (2011) Neurocytomas: long-term experience of a single institution. Neuro-Oncol 13:943–949
Chen H, Zhou R, Liu J, Tang J (2012) Central neurocytoma. J Clin Neurosci Off J Neurosurg Soc Australas 19:849–853
Qian H, Lin S, Zhang M, Cao Y (2012) Surgical management of intraventricular central neurocytoma: 92 cases. Acta Neurochir (Wien) 154:1951–1960
Kim JW, Kim DG, Kim IK et al (2013) Central neurocytoma: long-term outcomes of multimodal treatments and management strategies based on 30 years’ experience in a single institute. Neurosurgery 72:407–413
Nakagawa K, Aoki Y, Sakata K, Sasaki Y, Matsutani M, Akanuma A (1993) Radiation therapy of well-differentiated neuroblastoma and central neurocytoma. Cancer 72:1350–1355
Schild SE, Scheithauer BW, Haddock MG, Schiff D, Burger PC, Wong WW, Lyons MK (1997) Central neurocytomas. Cancer 79:790–795
Kim DG, Paek SH, Kim IH, Chi JG, Jung HW, Han DH, Choi KS, Cho BK (1997) Central neurocytoma: the role of radiation therapy and long term outcome. Cancer 79:1995–2002
Kulkarni V, Rajshekhar V, Haran RP, Chandi SM (2002) Long-term outcome in patients with central neurocytoma following stereotactic biopsy and radiation therapy. Br J Neurosurg 16:126–132
Anderson RC, Elder JB, Parsa AT, Issacson SR, Sisti MB (2001) Radiosurgery for the treatment of recurrent central neurocytomas. Neurosurgery 48:1231–1237
Hara M, Aoyagi M, Yamamoto M, Maehara T, Takada Y, Nojiri T, Ohno K (2003) Rapid shrinkage of remnant central neurocytoma after gamma knife radiosurgery: a case report. J Neurooncol 62:269–273
Brandes AA, Amistà P, Gardiman M, Volpin L, Danieli D, Guglielmi B, Carollo C, Pinna G, Turazzi S, Monfardini S (2000) Chemotherapy in patients with recurrent and progressive central neurocytoma. Cancer 88:169–174
Rades D, Schild SE (2006) Treatment recommendations for the various subgroups of neurocytomas. J Neurooncol 77:305–309
Rades D, Fehlauer F, Schild SE (2004) Treatment of atypical neurocytomas. Cancer 100:814–817
Bertalanffy A, Roessler K, Koperek O, Gelpi E, Prayer D, Knosp E (2005) Recurrent central neurocytomas. Cancer 104:135–142
Vasiljevic A, François P, Loundou A, Fèvre-Montange M, Jouvet A, Roche P-H, Figarella-Branger D (2012) Prognostic factors in central neurocytomas: a multicenter study of 71 cases. Am J Surg Pathol 36:220–227
Chen Y-D, Li W-B, Feng J, Qiu X-G (2014) Long-term outcomes of adjuvant radiotherapy after surgical resection of central neurocytoma. Radiat Oncol Lond Engl 9:242
Choudhari KA, Kaliaperumal C, Jain A, Sarkar C, Soo MYS, Rades D, Singh J (2009) Central neurocytoma: a multi-disciplinary review. Br J Neurosurg 23:585–595
Acknowledgments
This research was supported in part by the NIH Brain Tumor SPORE grant P50 CA097257 (DHK), Nancy and Stephen Grand Philanthropic Fund (DHK), and The V Foundation (DHK) as well as by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number TL1 TR000144 (BSI).
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Imber, B.S., Braunstein, S.E., Wu, F.Y. et al. Clinical outcome and prognostic factors for central neurocytoma: twenty year institutional experience. J Neurooncol 126, 193–200 (2016). https://doi.org/10.1007/s11060-015-1959-y
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DOI: https://doi.org/10.1007/s11060-015-1959-y