Format

Send to

Choose Destination
Neurosurgery. 2015 Oct;77(4):585-92; discussion 592-3. doi: 10.1227/NEU.0000000000000890.

The Long-term Outcome After Resection of Intraspinal Nerve Sheath Tumors: Report of 131 Consecutive Cases.

Author information

1
*Faculty of Medicine, University of Oslo, Oslo, Norway; ‡Departments of Neurosurgery and §Radiology, Oslo University Hospital, Oslo, Norway; ¶The Norwegian Cancer Registry, Oslo, Norway.

Abstract

BACKGROUND:

The existing literature on recurrence rates and long-term clinical outcome after resection of intraspinal nerve sheath tumors is limited.

OBJECTIVE:

To evaluate progression-free survival, overall survival, and long-term clinical outcome in a consecutive series of 131 patients with symptomatic intraspinal nerve sheath tumors.

METHODS:

Medical charts were retrospectively reviewed. Surviving patients voluntarily participated in a clinical history and physical examination that focused on neurological function and current tumor status.

RESULTS:

Follow-up data are 100% complete; median follow-up time was 6.1 years. All patients (100%) had surgery as the first line of treatment; gross total resection was performed in 112 patients (85.5%) and subtotal resection in 19 patients (14.5%). Five-year progression-free survival was 89%. The following risk factors for recurrence were identified: neurofibroma, malignant peripheral nerve sheath tumor, subtotal resection, neurofibromatoses/schwannomatosis, and advancing age at diagnosis. More than 95% of patients had neurological function compatible with an independent life at follow-up. The rate of tumor recurrence in nonneurofibromatosis patients undergoing total resection of a single schwannoma was 3% (3/93), in comparison with a recurrence rate of 32% (12/38) in the remaining patients.

CONCLUSION:

Gross total resection is the gold standard treatment for patients with intraspinal nerve sheath tumors. In a time of limited health care resources, we recommend that follow-up be focused on the subgroup of patients with a high risk of recurrence. The benefit of long-term, yearly magnetic resonance imaging follow-up with respect to recurrence in nonneurofibromatosis patients undergoing gross total resection of a single schwannoma is, in our opinion, questionable. 1NF2, neurofibromatosis 2NST, nerve sheath tumorOS, overall survivalPFS, progression-free survivalSTR, subtotal resectionWHO, World Health Organization.

PMID:
26191976
DOI:
10.1227/NEU.0000000000000890
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center