Clinical Outcomes and Prognostic Analysis of 101 Patients of Central Neurocytoma: A 10-Year Treatment Experience at a Single Institution

Qiongxuan Xie; Bin Xie; Ludi Ou; Min Wang; Ziqing Tang; Yuxiang He; Xiaoyu Yang; Jidong Hong; Zhiping Lyu; Rui Wei

doi:10.3389/fonc.2022.881460

Clinical Outcomes and Prognostic Analysis of 101 Patients of Central Neurocytoma: A 10-Year Treatment Experience at a Single Institution

Front Oncol. 2022 May 27:12:881460. doi: 10.3389/fonc.2022.881460. eCollection 2022.

Authors

Qiongxuan Xie^{1

2}, Bin Xie^{2

3}, Ludi Ou^{1

2}, Min Wang^{1

2}, Ziqing Tang^{1

2}, Yuxiang He^{1

2}, Xiaoyu Yang^{1

2}, Jidong Hong^{1

2}, Zhiping Lyu^{1

2}, Rui Wei^{1

2}

Affiliations

¹ Department of Oncology, Xiangya Hospital, Central South University, Changsha, China.
² National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
³ Department of Pathology, Xiangya Hospital, Central South University, Changsha, China.

Abstract

Objective: Central neurocytoma (CN) is a rare type of tumor that currently lacks an optimal treatment protocol. This study aimed to explore the clinical outcomes of CN in a cohort of 101 patients and identify prognostic factors associated with multiple treatment modalities.

Methods: This monocentric study retrospectively analyzed the clinical data of 101 CN patients who underwent surgical resection. The patients were followed up, and their overall survival (OS) and progression-free survival (PFS) were calculated.

Results: For the entire cohort, the 5- and 10-year OS rates were 88.7% and 82.8%, respectively, and the 5- and 10-year PFS rates were 86.5% and 64.9%, respectively. Of the 82 (81.19%) patients with CN who underwent gross total resection (GTR), 28 (28/82, 34.1%) also received radiotherapy (RT). Of the 19 (18.81%) patients with CN who underwent subtotal resection (STR), 11 (11/19, 57.9%) also received RT or stereotactic radiosurgery (SRS). Compared to STR, GTR significantly improved the 5-year OS (92.4% vs. 72.4%, P=0.011) and PFS (92.4% vs. 60.4%, P=0.009) rates. Radiotherapy did not affect OS in the GTR group (p=0.602), but it had a statistically significant effect on OS in the STR group (P<0.001). However, the OS (P=0.842) and PFS (P=0.915) in the STR plus radiotherapy group were comparable to those in the GTR alone group. Compared to STR alone, STR plus radiotherapy improved the 5-year PFS rate from 25% to 75% in patients with atypical CN (P=0.004). Cox regression models and a competing risk model showed that the removal degree and radiotherapy were independent prognostic factors for survival. With improvements in modern radiotherapy techniques, severe radiotherapy toxicity was not observed.

Conclusion: Our findings support the use of GTR whenever possible. Radiotherapy can improve the prognosis of patients who undergo STR, especially in atypical CNs having a higher tendency to relapse. Close imaging follow-up is necessary. Our findings will help clinicians to select optimal, individualized treatment strategies to improve OS and PFS for patients with CN.

Keywords: atypical neurocytoma; central neurocytoma; prognostic factors; radiotherapy; survival outcomes; treatment.