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Therapeutic Strategies and Prognostic Factors Based on 121 Spinal Neurenteric Cysts.

Authors
  • Weng, Jian-Cong1
  • Zhang, Zhi-Feng1, 2
  • Li, Da1
  • Wang, Jun-Mei3
  • Li, Gui-Lin3
  • Xu, Yu-Lun1
  • Yang, Jun1
  • Zhang, Jun-Ting1
  • Jia, Wen-Qing1
  • 1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China. , (China)
  • 2 Department of Neurosurgery, The Second Hospital of Hebei Medical University, Hebei, People's republic of china. , (China)
  • 3 Department of Neuropathology, Beijing Neurosurgical Institute, Beijing, People's Republic of China. , (China)
Type
Published Article
Journal
Neurosurgery
Publication Date
Apr 01, 2020
Volume
86
Issue
4
Pages
548–556
Identifiers
DOI: 10.1093/neuros/nyz143
PMID: 31081882
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Limited data existed to guide the management of intraspinal neurenteric cysts (ISNECs). To evaluate the risk factors for progression-free survival (PFS), elucidate the radiological features of ISNECs, and propose a treatment protocol. From 2003 to 2015, 121 patients with pathologically confirmed ISNECs treated at our institute were included in this study. Pertinent risk factors were evaluated. Gross total resection (GTR) was achieved in 55 (44.6%) patients; 106 (87.6%), 12 (9.9%), and 3 (2.5%) ISNECs were classified as Wilkins A, B, and C, respectively. After a median follow-up duration of 64.2 mo, recurrence occurred in 25 (22.7%) patients, with a median PFS time of 43.1 mo. The actuarial PFS rates at 5 and 10 yr were 73.2% and 66.2%, respectively. The actuarial overall survival rates at 5 and 10 yr were 100% and 97.6%, respectively. Non-GTR (hazard ratio [HR], 5.836; 95% confidence interval [CI], 1.698-20.058; P = .005), Wilkins B/C (HR, 3.129; 95% CI, 1.009-9.702; P = .048), and a history of surgical resection (HR, 3.690; 95% CI, 1.536-8.864; P = .004) were adverse factors. GTR and Wilkins A were favorable factors for PFS. If tolerable, GTR alone was advocated as an optimal treatment. Because of the benign nature and favorable prognosis, non-GTR was an alternative if GTR failed. Close follow-up was needed because of the recurrent tendency of ISNEC. Future study with a large cohort is necessary to verify our findings. Copyright © 2019 by the Congress of Neurological Surgeons.

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