Clinical outcome and prognostic factors for central neurocytoma: twenty year institutional experience

Brandon S. Imber, Steve E. Braunstein, Fred Y. Wu, Nima Nabavizadeh, Nicholas Boehling, Vivian K. Weinberg, Tarik Tihan, Michael Barnes, Sabine Mueller, Nicholas A. Butowski, Jennifer L. Clarke, Susan M. Chang, Michael M. McDermott, Michael D. Prados, Mitchel S. Berger, Daphne A. Haas-Kogan

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)193-200
Number of pages8
JournalJournal of Neuro-Oncology
Volume126
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Benign central nervous system tumor
  • Central neurocytoma
  • Intraventricular neurocytoma
  • MIB-1 labeling index
  • Progression free survival

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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