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Surgical Management of Sporadic Peripheral Nerve Schwannomas in Adults: Indications and Outcome in a Single Center Cohort. | LitMetric

AI Article Synopsis

  • Most peripheral nerve sheath tumors in adults are schwannomas, typically causing pain and neurological issues, requiring a multidisciplinary approach for successful surgical treatment.
  • A study of 414 patients who underwent surgery for these tumors revealed that 92.5% achieved complete tumor removal, with significant improvements in symptoms for 89.1% of cases.
  • While the surgery is generally safe and effective, recurrent tumors were less likely to be completely resected, and tumors in certain locations, like the cervical neurovascular bundle, posed more challenges.

Article Abstract

Most sporadic peripheral nerve sheath tumors in adults are schwannomas. These tumors usually present with significant pain but can also cause neurological deficits. Symptomatology is diverse, and successful surgical interventions demand interdisciplinarity. We retrospectively reviewed 414 patients treated between 2006 and 2017 for peripheral nerve sheath tumors. We analyzed clinical signs, symptoms, histology, and neurological function in the cohort of adult patients with schwannomas without a neurocutaneous syndrome. In 144 patients, 147 surgical interventions were performed. Mean follow-up was 3.1 years. The indication for surgery was pain (66.0%), neurological deficits (23.8%), significant tumor growth (8.8%), and suspected malignancy (1.4%). Complete tumor resection was achieved on 136/147 occasions (92.5%). The most common location of the tumors was intraspinal (49.0%), within the cervical neurovascular bundles (19.7%), and lower extremities (10.9%). Pain and neurological deficits improved significantly ( ≤ 0.003) after 131/147 interventions (89.1%). One patient had a persistent decrease in motor function after surgery. Complete resection was possible in 67% of recurrent tumors, compared to 94% of primary tumors. There was a significantly lower chance of complete resection for schwannomas of the cervical neurovascular bundle as compared to other locations. The surgical outcome of sporadic schwannoma surgery within the peripheral nervous system is very favorable in experienced peripheral nerve surgery centers. Surgery is safe and effective and needs a multidisciplinary setting. Early surgical resection in adult patients with peripheral nerve sheath tumors with significant growth, pain, neurological deficit, or suspected malignancy is thus recommended.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957633PMC
http://dx.doi.org/10.3390/cancers13051017DOI Listing

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