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

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

World Neurosurg. 2017 Aug 31;:

Authors: Weng JC, Li D, Li H, Ma JP, Tian KB, Wang L, Zhang LW, Wu Z, Zhang JT

Abstract
OBJECTIVE: Management of intracranial chondromas (ICDs) is difficult. This study aims to propose a tailored management strategy based on our management of ICDs.
METHODS: A 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 (OS) were evaluated.
RESULTS: The pre- and postoperative KPS 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 (HR 6.876; 95%CI 1.599-29.560; p=0.010), tumor size ≥3.1cm (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 (PR) (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.
CONCLUSIONS: The therapeutic strategy for ICDs should be individualized and should consider preoperative variables. GTR was attempted if the tumors were resectable; otherwise, subtotal resection was alternative. In patients with both PR and evident atypia/mitotic activity, consultation with oncologist for radiotherapy was recommended.

PMID: 28867324 [PubMed - as supplied by publisher]

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