Therapeutic Strategies and Prognostic Factors Based on 121 Spinal Neurenteric Cysts. Issue 4 (13th May 2019)

• Record Type: Journal Article
• Authors: Weng, Jian-Cong; Zhang, Zhi-Feng; Li, Da; Wang, Jun-Mei; Li, Gui-Lin; Xu, Yu-Lun; Yang, Jun; Zhang, Jun-Ting; Jia, Wen-Qing
• Is Part Of: Neurosurgery. Volume 86:Issue 4(2020)
• Page Start: 548
• Page End: 556
• Publication Date: 2019-05-13
• Subjects: Extramedullary -- Intramedullary -- Neurenteric cyst -- Prognosis factors -- Treatment strategy; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyz143
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: BACKGROUND: Limited data existed to guide the management of intraspinal neurenteric cysts (ISNECs). OBJECTIVE: To evaluate the risk factors for progression-free survival (PFS), elucidate the radiological features of ISNECs, and propose a treatment protocol. METHODS: From 2003 to 2015, 121 patients with pathologically confirmed ISNECs treated at our institute were included in this study. Pertinent risk factors were evaluated. RESULTS: 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. CONCLUSION: 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.