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Long term outcomes and predictors of recurrence in central neurocytomas: a 35-year multi-institutional experience
Yufan Yang1,2, James L Leenstra3, Paul D Brown3
1Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48109, USA.
Introduction:
Central neurocytomas (CNs) are rare, WHO grade 2 brain tumors that have relatively high recurrence rates following resection. The present collaboration between Northwestern University and the Mayo Clinic describes long-term outcomes of CN as it relates to potential prognostic variables that entail recurrence risk, such as RT timing, tumor proliferation index (Ki-67), and age at diagnosis.
Methods:
Patients established between 1990 and 2025 with a tissue diagnosis of CN were reviewed. Recurrence free survival (RFS) and overall survival (OS) were calculated according to the Kaplan Meier-method. Multivariate cox regression analysis was performed with pre-planned variables.
Results:
Fifty-one patients with CN with a median age of 26 years and 9.7 years median follow-up were included. OS at 10 years for the cohort was 94%. Without adjuvant RT, 5-year RFS for post-GTR was 61% versus 46% for post-STR (P value = 0.18). Multivariate analysis found omission of adjuvant RT (HR: 9.0, P = 0.003), subtotal resection (HR:5.7, P = 0.017), younger age at diagnosis (HR3.1, P = 0.002), and higher Ki-67 (HR 1.13, P = 0.017) were associated with worse RFS. Salvage RT after first recurrence (n = 17) had a 5-year RFS of 83%, with a median follow-up of 4.8 years.
Conclusions:
We report one of the largest and most comprehensive cohorts of CN with long-term follow-up. Contrary to previous reports, recurrences were frequent after GTR. Higher Ki-67 and age at diagnosis were associated with worse RFS in our cohort. Salvage RT at recurrence achieved durable long-term tumor control, and 10-year mortality was low.