Central neurocytoma: management recommendations based on a 35-year experience

Area of Science:

• Neuro-oncology
• Neurosurgery
• Radiation Oncology

Background:

• Central neurocytomas are rare tumors typically arising in the suprasellar region or lateral ventricles.
• While generally considered low-grade, a subset exhibits aggressive behavior and recurrence.
• Understanding prognostic factors and optimal treatment strategies is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the long-term outcomes of patients diagnosed with central neurocytomas.
• To identify factors influencing survival and local control.
• To assess the role of surgery, radiotherapy, and chemotherapy in managing these tumors.

Main Methods:

• Retrospective analysis of 45 patients with histologically confirmed central neurocytomas diagnosed between 1971 and 2003.
• Evaluation of treatment modalities including surgery, radiotherapy (RT), and chemotherapy.
• Assessment of prognostic factors such as mitotic index, tumor type (typical vs. atypical), and extent of resection.

Main Results:

• The 10-year overall survival and local control rates were 83% and 60%, respectively.
• Lower mitotic index (<3) and typical tumor histology were associated with better outcomes.
• Postoperative RT significantly improved local control (75% vs. 51%) but not overall survival.

Conclusions:

• Central neurocytomas generally have a favorable prognosis, but tumor recurrence remains a concern.
• Adjuvant radiotherapy should be considered for atypical or high-mitotic index tumors, especially with incomplete resection.
• While postoperative RT improves local control, salvage RT may explain the lack of survival benefit.