Outcome of Therapies for Central Neurocytomas in Children
Outcome After Surgery
Dependent on extent of resection: Total tumor resection is associated with good clinical outcomes (5-year survival rate, 81%). However, in incomplete resections and in atypical neurocytomas, recurrence rates have been quoted to be around 44% (31).
Better for typical than for atypical neurocytomas: In a meta-analysis of 438 patients (31), 73 of whom were children, typical lesions were associated with better local control than atypical ones (p<0.001). Complete tumor resection was superior to incomplete resection (p< 0.001).
Outcome After Nonsurgical Treatments
Conventional radiotherapy – satisfactory: In a study of stereotactic biopsy and radiotherapy, the authors (43) concluded that the long-term results were satisfactory. However, radiotherapy needs to be used only for incomplete resections or aggressive lesions, as the typical lesion is benign and completely manageable with surgery alone.
Stereotactic radiosurgery – good: Good results have also been reported with stereotactic radiosurgery (42, 43). One study comparing results of conventional radiotherapy with stereotactic radiosurgery in incompletely resected tumors did not find any significant difference between the two modalities (44).
Outcome After Multimodal Therapies
No benefit with gross total resection: After complete tumor resection, outcome was not significantly affected by radiotherapy in any form.
Questionable benefit with subtotal resection: After incomplete tumor resection, radiotherapy improved survival in typical lesions (p=0.03) and atypical lesions (p=0.05), but, significantly, not in children (p=0.16). Local control was improved, however, in children (p=0.01).