Brandon Stuart Imber MA, Presenter: Nothing to Disclose

Steve Braunstein MD, Abstract Co-Author: Nothing to Disclose

Fred Yong-Tao Wu MD, PhD, Abstract Co-Author: Nothing to Disclose

Nicholas Boehling BA, Abstract Co-Author: Nothing to Disclose

Nima Nabavizadeh MD, Abstract Co-Author: Nothing to Disclose

Vivian Weinberg PhD, Abstract Co-Author: Nothing to Disclose

Susan Chang MD, Abstract Co-Author: Nothing to Disclose

Michael McDermott MD, Abstract Co-Author: Nothing to Disclose

Daphne Adele Haas-Kogan MD, Abstract Co-Author: Research, Novartis AG

Central neurocytomas are intraventricular central nervous system neoplasms that comprise 0.25-0.5% of brain tumors. Optimal management remains controversial due to their rarity. We assessed clinical outcomes for a historical cohort of neurocytoma patients and evaluated effects of tumor pathologic grade and atypia, tumor size, extent of resection (EOR), and adjuvant radiation (RT).

Progression-free survival (PFS) was measured from date of first surgical resection. Minimum follow-up of 6 months was required for inclusion in analysis. Differences in PFS were measured by Kaplan-Meier and Cox proportional hazard ratio methods. Tumor atypia was defined as MIB-1 index >2%, focal necrosis, or microvascular proliferation, as previously established.

A total of 22 patients (14 males, 8 females) were treated between 1995 and 2009, with median age at diagnosis of 24 years (range 11-62 years). One patient died perioperatively and 4 patients were lost to follow-up prior to 6 months and excluded from analysis. A total of 7 patients experienced recurrent/progressive disease. Median PFS and OS were 52 months (range 6-210) and 86 months (range 24-210), respectively. Two patients died of disease, both of whom had atypical tumors. There was near 100% concordance between tumor atypia and MIB-1 labeling. Three-year PFS was 57% for MIB labeling >2% and 100% for MIB labeling ≤ 2% (HR 8.1, CI 1.1–58.2, p = 0.04). Median tumor diameter at diagnosis was 4.1 cm (range 0.8-8.6 cm). Three-year PFS was 44% for tumors >4.3 cm and 89% for tumors ≤4.3 cm (HR 3.0, CI 0.76–12.2, p= 0.12). We examined influence of EOR and adjuvant RT. Four patients had gross total resection (GTR) and 13 had subtotal resection (STR). Six patients progressed after STR. None of the GTR patients received adjuvant RT and four of the STR patients received adjuvant RT. Three-year PFS was 100% with RT and 67% without RT (HR 0.44, CI 0.08-2.41 p=0.34).

For patients with central neurocytoma, MIB-1 labeling index >2% is predictive of worse outcome. Although patient numbers were limited, our data indicate that lesser extent of resection and larger tumor size may confer poorer prognosis and adjuvant RT after STR may improve PFS.

Greater tumor atypia, as quantified by MIB-1 labeling index >2%, is predictive of poorer outcomes in patients with central neurocytoma.

Imber, B, Braunstein, S, Wu, F, Boehling, N, Nabavizadeh, N, Weinberg, V, Chang, S, McDermott, M, Haas-Kogan, D, Clinical Outcomes and Prognostic Factors for Central Neurocytoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015333.html