[Central neurocytomas: long-term treatment outcomes]

Area of Science:

• Neuro-oncology
• Neurosurgery
• Radiation Oncology

Background:

• Central neurocytoma is a rare, benign brain tumor that can cause significant mass effect.
• Treatment involves surgical resection and CSF circulation restoration, but total resection is often challenging.
• Tumor progression necessitates further management, with historical reliance on re-operation and emerging use of stereotactic irradiation.

Purpose of the Study:

• Evaluate postoperative outcomes in central neurocytoma patients.
• Analyze recurrence-free survival and associated risk factors.
• Assess the effectiveness of treatments for tumor progression and delayed complications.

Main Methods:

• Long-term follow-up of 84 patients with central neurocytoma post-surgery (2008-2017).
• Analysis of recurrence-free survival, risk factors (resection quality, Ki-67 index), and treatment outcomes.
• Evaluation of redo resection and stereotactic irradiation for tumor progression.

Main Results:

• Two-year recurrence-free survival was 94%, and 5-year survival was 83%.
• Tumor progression occurred in 30.19% of patients, with resection quality and Ki-67 index as key risk factors.
• Redo resection (7 cases) and stereotactic irradiation (11 cases) demonstrated effective tumor growth control.

Conclusions:

• Surgical resection of central neurocytoma can achieve long-term recurrence-free periods.
• Partial resection and high Ki-67 index (>5%) are primary drivers of recurrence.
• Redo resection is indicated for progression with CSF flow impairment; stereotactic irradiation is effective for growth without intracranial hypertension.