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Central Neurocytoma Treatment Modalities: A Systematic Review Assessing the Outcomes of Combined Maximal Safe Resection and Radiotherapy with Gross Total Resection

Central Neurocytoma Treatment Modalities: A Systematic Review Assessing the Outcomes of Combined Maximal Safe Resection and Radiotherapy with Gross Total Resection

Authors :
Michael E. Ivan
Evan Luther
Ricardo J Komotar
Anil K. Mahavadi
Ashish H. Shah
Priyen M. Patel
Daniel G Eichberg
Manish Kuchakulla
Source :
World Neurosurgery. 137:e176-e182
Publication Year :
2020
Publisher :
Elsevier BV, 2020.

Abstract

Background Central neurocytomas (CNCs) are rare intraventricular lesions comprising Objective Our goal was to update Rades et al.‘s 2006 systematic review to assess the outcome differences among 3 fundamental therapies for CNC: gross total resection with and without radiation therapy (RT) versus maximal safe resection with adjuvant RT. Methods Articles indexed on PubMed and Google Scholar and published between January 1, 2006 and December 31, 2019 were selected using the PRISMA criteria. Studies were excluded if they had fewer than 3 cases, did not categorize extent of resection, or were duplicate studies, technical reports, case reports, or studies without follow-up. Complication rates, recurrence rates, overall survival and progression-free survival were extracted where possible. χ2 proportionality tests were used for comparison (P values >0.05 suggested significance). Results On aggregation, 615 patients from 13 studies including ours were assessed. Although overall survival was not significantly different (χ2 = 1.56; P = 0.46), the recurrence rate differed significantly between GTR + RT (6.9%, 92.11 months), GTR–RT (23.9%, 96.8 months), and MSR + RT (16.8%, 85 months) (χ2 = 10.94; P = 0.004). Pooled complication rates for GTR and MSR + RT were 31.2% and 24% (P = 0.049), respectively. Conclusions RT remains an important adjuvant treatment that can improve patient survival in the presence of MSR to levels comparable to those of GTR or GTR + RT. Where total resection carries too much risk, MSR + RT can be considered as the next best alternative for tumor control.

Details

ISSN :
18788750
Volume :
137
Database :
OpenAIRE
Journal :
World Neurosurgery
Accession number :
edsair.doi.dedup.....8eba697670661990fedc9de94abc5eee
Full Text :
https://doi.org/10.1016/j.wneu.2020.01.114