METHODS: All adult patients (age 18 years or older) newly diagnosed with a histologically confirmed neurocytoma between 2006 and 2015 in France were included.
RESULTS: One hundred and sixteen patients were diagnosed with a central neurocytoma during the study period. All patients underwent surgical resection, and six received adjuvant radiotherapy. Eleven patients received radiotherapy due to progression. After a median follow-up of 68.7 months, local failure occurred in 29 patients. The 5-year local control rate was 73.4%. According to univariate analysis, marker of proliferation Ki67 index greater than 2% (hazard ratio [HR]: 1.48; confidence interval [CI]: 1.40-1.57; P=0.027) and subtotal resection (HR: 8.48; CI: 8.01-8.99; P<0.001) were associated with an increase in local failure. Gross total resection was associated with a higher risk of sequelae epilepsy (HR: 3.62; CI: 3.42-3.83; P<0.01) and memory disorders (HR: 1.35; CI: 1.07-1.20; P<0.01). Ten patients (8.6%) died during the follow-up. The 10-year overall survival rate was 89.0%. No prognostic factors for overall survival were found.
CONCLUSIONS: The analysis showed that patients who underwent subtotal surgical resection, particularly when the tumour had a Ki67 index greater than 2%, had an increased risk of local recurrence. These patients could benefit from adjuvant radiotherapy.
方法:纳入了法国2006年至2015年间新诊断为组织学确诊的神经细胞瘤的所有成年患者(18岁或以上)。
结果:研究期间有116例患者被诊断为中枢神经细胞瘤。所有患者均行手术切除,6人接受了辅助放疗。11例患者因病情进展接受放疗。在中位随访68.7个月后,29例患者发生局部衰竭。5年局部控制率为73.4%。根据单变量分析,增殖标志物Ki67指数大于2%(风险比[HR]:1.48;置信区间[CI]:1.40-1.57;P=0.027)和次全切除(HR:8.48;CI:8.01-8.99;P<0.001)与局部衰竭增加相关.总切除与癫痫后遗症(HR:3.62;CI:3.42-3.83;P<0.01)和记忆障碍(HR:1.35;CI:1.07-1.20;P<0.01)的风险较高。随访期间死亡10例(8.6%)。10年总生存率为89.0%。没有发现总生存期的预后因素。
结论:分析表明,接受手术次全切除的患者,特别是当肿瘤的Ki67指数大于2%时,局部复发的风险增加。这些患者可以从辅助放疗中获益。