Atypical Central Neurocytoma: An Investigation of Prognostic Factors.

OBJECTIVE: Central neurocytoma is a rare nervous tissue benign neoplasm. A subset of central neurocytoma has unfamiliar aggressive tendency: so-called atypical central neurocytoma (ACN). This retrospective study aims to analyze the prognostic factors and the impact of various therapy tools on atypical central neurocytoma. METHODS: Twenty-two patients diagnosed with ACN between January 2009 and March 2018 were included. Data collected included the patient's age, gender, tumor location, presenting symptoms, and treatment received. Patients were followed up to detect recurrence and to assess survival. RESULTS: Median overall survival was 57 months, with a 5-year survival of 35%. Better survival was observed for patients <35 years old (66 vs. 47 months; P = 0.061) and patients with gross total resection over subtotal resection or biopsy (76, 45, and 22 months, respectively; P < 0.0001). Patients with a tumor located in the posterior half of the lateral ventricle had better survival, with no statistical significance (P = 0.053). Multivariate analysis showed prognostic significance with the extent of resection (P = 0.000). Progression-free survival ranged from 6 to 82 months, with a median value of 38 months and showed a significant relation with subtotal resection compared with biopsy (P = 0.006). Recurrence was less in patients who received radiotherapy and was statistically significant (P = 0.007). CONCLUSIONS: Long-term survival is possible for patients with atypical central neurocytomas treated with surgery and postoperative radiation. Multivariate analysis confirmed that gross total resection was an independent prognostic factor for survival. Adjuvant radiotherapy reduces tumor recurrence, especially after incomplete surgery.

Prognostic Factors for Olfactory Dysfunction in Adult Mild Head Trauma.

BACKGROUND: Although posttraumatic olfactory disturbances are frequent, they have a poor prognosis. Our study aimed to investigate the impact of clinical factors on the progress of these olfactory disturbances. METHODS: Among patients admitted with evidence of head trauma, only suspected cases of posttraumatic olfactory disturbances were included. Patients were examined by the Sniffin'Sticks test, early posttraumatic and then later after recovery. Such factors as age, sex, olfactory bulb status, and observation period were enrolled in logistic regression analysis, because they are considered to have a possible influence on olfactory function improvements. Amelioration of olfaction was expressed as an alteration in olfactory function to a better level. RESULTS: A total of 70 patients were involved, with a mean age of 38 years. The mean duration of follow-up was 6 months. Twelve patients (17.1%) had olfactory function improvements. In univariate and multivariate analyses, no clinical factors had an impact on olfactory recovery (all P > 0.05) except olfactory bulb integrity, which appears to influence improvement in olfactory function (P = 0.0327 and 0.0293). CONCLUSIONS: Olfactory bulb integrity, probably the sole prognostic factor for posttraumatic olfactory recovery, where frank damage to such a structure carries a prognosis of poor posttraumatic olfactory function.

Atypical meningioma: a study of prognostic factors.

OBJECTIVE: Atypical meningiomas represent 20% of all meningiomas. This retrospective study analyzes the prognostic factors, the effect of different methods of treatments, and the behavior of atypical meningiomas. METHODS: The study comprised 44 patients who were given a diagnosis of atypical meningioma according to the 2007 World Health Organization classification in the period from January 2009 to March 2012. Data collected included patient age, gender, tumor location, presenting symptoms, and treatment received. Patients were followed to detect recurrence and assess survival. RESULTS: Median overall survival was 57 months, with a 5-year survival of 35%. Significantly better survival was observed for patients <50 years old (65 months vs. 46 months, P = 0.033) and patients with total resection (Simpson grade 1-2) compared with subtotal resection (Simpson grade 3-4) or biopsy (Simpson grade 5) (75 months vs. 46 months and 24 months, P < 0.0001). Patients with a tumor located in brain convexity had better survival but with no statistical significance (P = 0.052). Multivariate analysis showed prognostic significance with age (P = 0.030) and extent of resection (P < 0.000). Progression-free survival ranged from 7-83 months with a median of 39 months. Progression-free survival showed a significant relationship with subtotal resection compared with biopsy (P = 0.007). Recurrences were less in patients who received radiotherapy (RT), and this was statistically significant (P = 0.007). CONCLUSIONS: Long-term survival is possible for patients with atypical meningiomas treated with surgery and postoperative RT. Multivariate analysis confirmed that age (<50 years) and total surgical excision were independent prognostic factors for survival. Adjuvant RT reduces tumor recurrence, especially after incomplete surgery.