• World Neurosurg · Dec 2017

    Surgical management and outcomes of intracranial chondromas: a single-center case series of 66 patients.

    • Jian-Cong Weng, Da Li, Huan Li, Jun-Peng Ma, Kai-Bing Tian, Liang Wang, Li-Wei Zhang, Wang Jia, Zhen Wu, and Jun-Ting Zhang.
    • Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases; Center of Brain Tumor, Beijing Institute for Brain Disorders; and Beijing Key Laboratory of Brian Tumor, Beijing, People's Republic of China.
    • World Neurosurg. 2017 Dec 1; 108: 264-277.

    ObjectiveManagement of intracranial chondromas (ICDs) is difficult. This study aims to propose a tailored management strategy based on our management of ICDs.MethodsA retrospective review was performed in 66 patients who received surgical operations at our institute. Clinical charts and radiographs were reviewed, follow-up was performed, and adverse factors for progression-free survival (PFS) and overall survival were evaluated.ResultsThe preoperative and postoperative Karnofsky performance status was 81.8 and 72.3, respectively. The mean tumor size was 3.5 cm. Gross total resection was achieved in 15 patients (22.7%). Six patients (10.3%) received postoperative radiation. After a mean follow-up duration of 85.5 months, recurrence occurred to 15 patients (28.8%) with surgery alone, and no recurrence was observed in patients receiving postoperative radiotherapy. Six patients (10.3%) died due to tumor progression. The risk factors affecting the PFS included age <33 years (hazard rate [HR] 6.876; 95% confidence interval [CI] 1.599-29.560; P = 0.010), tumor size ≥3.1 cm (HR 6.138; 95% CI 1.259-29.926; P = 0.025), tumor with evident atypia/mitotic activity (HR 4.672; 95% CI 1.352-16.152; P = 0.015), and partial resection (HR 12.841; 95% CI 3.004-54.896; P = 0.001). In all patients, the PFS rate was 75% at 5 years and 64% at 10 years; in addition, the overall survival rate was 93% at 5 years and 83% at 10 years.ConclusionsThe therapeutic strategy for ICDs should be individualized and should consider preoperative variables. Gross total resection was attempted if the tumors were resectable; otherwise, subtotal resection was an alternative. In patients with partial resection and evident atypia/mitotic activity, consultation with an oncologist for radiotherapy was recommended.Copyright © 2017 Elsevier Inc. All rights reserved.

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