[Head and neck neurofibromas: analysis of 46 cases]

To investigate the surgical mode, recurrence and prognosis for patients with head and neck neurofibromas and explore their treatment strategies.

The clinicopathological features, operation mode, prognosis and neural function of 46 patients with head and neck neurofibroma were analyzed retrospectively, and 41 of the cases were followed up for 24-170 months (median 74 months).

Among the 41 followed-up patients, 26 patients were cured and 15 patients were not cured (two died). The cure rate of the neurofibromas with neurofibromatosis type 1 (NF1) and the neurofibromas without NF1 were 42.9% and 85.0%, respectively (P = 0.005). The cure rate of localized, aggressive, diffuse and beaded neurofibromas were 100.0%, 46.6%, 40.0% and 66.7%, respectively (P = 0.009). The cure rate of radical resection (including expanding excision and complete resection) and partial resection were 73.5% and 14.3%, respectively (P = 0.011). The cure rates of expanding excision and partial resection were 80.0% and 14.3% (P = 0.029). The cure rates of complete resection and partial resection were 70.8% and 14.3%, respectively (P = 0.026). However, the cure rates of expanding excision and complete resection were not significantly different (P = 0.581). Multivariate Cox model analysis indicated that thoroughness of surgery was the independent risk factor for the prognosis for patients with head and neck neurofibromas.

Neurofibroma is a kind of aggressive benign tumors. Some neurofibromas have a high recurrence rate and low recovery rate, and some nerves are essay to be injured in the operation. Lots of factors impact on the prognosis and recovery of the neural function. Therefore, operation opportunity and mode should be carefully selected.