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01-09-2013 | Clinical Study

The fate of spinal schwannomas following subtotal resection: a retrospective multicenter study by the Korea spinal oncology research group

Authors: Seil Sohn, Chun Kee Chung, Sung-Hye Park, Eun-Sang Kim, Ki-Jeong Kim, Chi Heon Kim

Published in: Journal of Neuro-Oncology | Issue 3/2013

Abstract

The fate of residual spinal schwannomas needs to be estimated in order to plan further management after subtotal removal. Our aim was to evaluate the growth rate of residual spinal schwannomas and compare results in regrowth and no regrowth groups by using data collected from the Korea Spinal Oncology Research Group database. From January 1989 to August 2011, 27 patients with residual spinal schwannomas were selected. Patients with at least two follow-up magnetic resonance image (MRI) studies after subtotal resection were included. The mean period of MRI follow-up was 62.4 months. A tumor size increase of over 2 mm in the maximal diameter was considered indicative of regrowth. Age, sex, size at initial diagnosis, postoperative tumor size, and Ki-67 labeling index were compared between regrowth and no regrowth groups. Eight residual schwannomas regrew (29.6 %), and 19 (70.4 %) did not regrow. Average growth rate of the regrowing tumors was 1.0 ± 4.4 mm/year. The mean percentage increase in tumor size during follow-up was 10.0 ± 28.8 %. The Ki-67 labeling indices were significantly different between regrowth and no regrowth groups (P = 0.014). Two patients underwent a revision operation for significant tumor regrowth. Nineteen cases (70.4 %) among 27 residual spinal schwannomas did not regrow significantly, but further surgical treatments were necessary in 2 patients due to significant regrowth. The Ki-67 labeling index was higher in the regrowth group. Earlier follow-up MRI is recommended for patients whose tumors have higher Ki-67.

Celli P, Trillo G, Ferrante L (2005) Spinal extradural schwannoma. J Neurosurg Spine 2(4):447–456PubMedCrossRef

Seppala MT, Haltia MJ, Sankila RJ, Jaaskelainen JE, Heiskanen O (1995) Long-term outcome after removal of spinal schwannoma: a clinicopathological study of 187 cases. J Neurosurg 83(4):621–626PubMedCrossRef

Conti P, Pansini G, Mouchaty H, Capuano C, Conti R (2004) Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature. Surg Neurol 61(1):34–43; discussion 44

Safavi-Abbasi S, Senoglu M, Theodore N et al (2008) Microsurgical management of spinal schwannomas: evaluation of 128 cases. J Neurosurg Spine 9(1):40–47PubMedCrossRef

Ozawa H, Onoda Y, Aizawa T, Nakamura T, Koakutsu T, Itoi E (2012) Natural history of intradural-extramedullary spinal cord tumors. Acta Neurol Belg 112(3):265–270PubMedCrossRef

Fukuda M, Oishi M, Hiraishi T, Natsumeda M, Fujii Y (2011) Clinicopathological factors related to regrowth of vestibular schwannoma after incomplete resection. J Neurosurg 114(5):1224–1231PubMed

Linthicum FH Jr, Saleh ES, Hitselberger WE, Brackmann DE, Hung G (2002) Growth of postoperative remnants of unilateral vestibular nerve schwannoma: role of the vestibular ganglion. ORL J Otorhinolaryngol Relat Spec 64(2):138–142PubMedCrossRef

Ohta S, Yokoyama T, Nishizawa S, Uemura K (1998) Regrowth of the residual tumour after acoustic neurinoma surgery. Br J Neurosurg 12(5):419–422PubMedCrossRef

El-Kashlan HK, Zeitoun H, Arts HA, Hoff JT, Telian SA (2000) Recurrence of acoustic neuroma after incomplete resection. Am J Otol 21(3):389–392PubMedCrossRef

10.

Cerullo L, Grutsch J, Osterdock R (1998) Recurrence of vestibular (acoustic) schwannomas in surgical patients where preservation of facial and cochlear nerve is the priority. Br J Neurosurg 12(6):547–552PubMedCrossRef

11.

Kameyama S, Tanaka R, Honda Y, Hasegawa A, Yamazaki H, Kawaguchi T (1994) The long-term growth rate of residual acoustic neurinomas. Acta Neurochir (Wien) 129(3–4):127–130CrossRef

12.

Kameyama S, Tanaka R, Kawaguchi T, Honda Y, Yamazaki H, Hasegawa A (1996) Long-term follow-up of the residual intracanalicular tumours after subtotal removal of acoustic neurinomas. Acta Neurochir (Wien) 138(2):206–209CrossRef

13.

Sridhar K, Ramamurthi R, Vasudevan MC, Ramamurthi B (2001) Giant invasive spinal schwannomas: definition and surgical management. J Neurosurg 94(2 Suppl):210–215PubMed

14.

Park SC, Chung SK, Choe G, Kim HJ (2009) Spinal intraosseous schwannoma: a case report and review. J Korean Neurosurg Soc 46(4):403–408PubMedCrossRef

15.

Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428PubMedCrossRef

16.

Grayeli AB, Kalamarides M, Ferrary E et al (2005) Conservative management versus surgery for small vestibular schwannomas. Acta Otolaryngol 125(10):1063–1068CrossRef

17.

Yoshimoto Y (2005) Systematic review of the natural history of vestibular schwannoma. J Neurosurg 103(1):59–63PubMedCrossRef

18.

Raut VV, Walsh RM, Bath AP et al (2004) Conservative management of vestibular schwannomas—second review of a prospective longitudinal study. Clin Otolaryngol Allied Sci 29(5):505–514PubMedCrossRef

19.

Rohit Piccirillo E, Jain Y, Augurio A, Sanna M (2006) Preoperative predictive factors for hearing preservation in vestibular schwannoma surgery. Ann Otol Rhinol Laryngol 115(1):41–46PubMed

20.

Bakkouri WE, Kania RE, Guichard JP, Lot G, Herman P, Huy PT (2009) Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequences for treatment. J Neurosurg 110(4):662–669PubMedCrossRef

21.

Bederson JB, von Ammon K, Wichmann WW, Yasargil MG (1991) Conservative treatment of patients with acoustic tumors. Neurosurgery 28(5):646–650; discussion 650–641

22.

Stangerup SE, Caye-Thomasen P, Tos M, Thomsen J (2006) The natural history of vestibular schwannoma. Otol Neurotol 27(4):547–552PubMedCrossRef

23.

Gerdes J, Schwab U, Lemke H, Stein H (1983) Production of a mouse monoclonal antibody reactive with a human nuclear antigen associated with cell proliferation. Int J Cancer 31(1):13–20PubMedCrossRef

24.

O’Reilly BF, Kishore A, Crowther JA, Smith C (2004) Correlation of growth factor receptor expression with clinical growth in vestibular schwannomas. Otol Neurotol 25(5):791–796PubMedCrossRef

25.

Brown DC, Gatter KC (2002) Ki67 protein: the immaculate deception? Histopathology 40(1):2–11PubMedCrossRef

26.

Yokoyama M, Matsuda M, Nakasu S, Nakajima M, Handa J (1996) Clinical significance of Ki-67 staining index in acoustic neurinoma. Neurol Med Chir (Tokyo) 36(10):698–702; discussion 702–693

27.

Niemczyk K, Vaneecloo FM, Lecomte MH et al (2000) Correlation between Ki-67 index and some clinical aspects of acoustic neuromas (vestibular schwannomas). Otolaryngology-Head Neck Surg 123(6):779–783CrossRef

28.

Aguiar PH, Tatagiba M, Samii M, Dankoweittimpe E, Ostertag H (1995) The comparison between the growth fraction of bilateral vestibular schwannomas in neurofibromatosis-2 (NF2) and unilateral vestibular schwannomas using the monoclonal-antibody MIB 1. Acta Neurochir (Wien) 134(1–2):40–45CrossRef

29.

Saito K, Kato M, Susaki N, Nagatani T, Nagasaka T, Yoshida J (2003) Expression of Ki-67 antigen and vascular endothelial growth factor in sporadic and neurofibromatosis type 2-associated schwannomas. Clin Neuropathol 22(1):30–34PubMed

30.

Antinheimo J, Haapasalo H, Seppala M, Sainio M, Carpen O, Jaaskelainen J (1995) Proliferative potential of sporadic and neurofibromatosis 2-associated schwannomas as studied by MIB-1 (Ki-67) and PCNA labeling. J Neuropathol Exp Neurol 54(6):776–782PubMedCrossRef

31.

Nakamura M, Iwanami A, Tsuji O et al (2013) Long-term surgical outcomes of cervical dumbbell neurinomas. J Orthop Sci 18(1):8–13PubMedCrossRef

32.

Kufeld M, Wowra B, Muacevic A, Zausinger S, Tonn JC (2012) Radiosurgery of spinal meningiomas and schwannomas. Technol Cancer Res Treat 11(1):27–34PubMed

33.

Gerszten PC, Chen S, Quader M, Xu YG, Novotny J, Flickinger JC (2012) Radiosurgery for benign tumors of the spine using the Synergy S with cone-beam computed tomography image guidance. J Neurosurg 117:197–202PubMedCrossRef

34.

Fawcett KJ, Dahlin DC (1967) Neurilemmoma of bone. Am J Clin Pathol 47(6):759–766PubMed

Title: The fate of spinal schwannomas following subtotal resection: a retrospective multicenter study by the Korea spinal oncology research group
Authors: Seil Sohn
Chun Kee Chung
Sung-Hye Park
Eun-Sang Kim
Ki-Jeong Kim
Chi Heon Kim
Publication date: 01-09-2013
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 3/2013
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-013-1190-7

At a glance: The STEP trials

Springer Medicine

The fate of spinal schwannomas following subtotal resection: a retrospective multicenter study by the Korea spinal oncology research group

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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