title: The Long-term Outcome After Resection of Intraspinal Nerve Sheath Tumors: Report of 131 Consecutive Cases.
abstract: BACKGROUND
  The existing literature on recurrence rates and long-term clinical outcome after resection of intraspinal nerve sheath tumors is limited.
  
  
  OBJECTIVE
  To evaluate progression-free survival, overall survival, and long-term clinical outcome in a consecutive series of 131 patients with symptomatic intraspinal nerve sheath tumors.
  
  
  METHODS
  Medical charts were retrospectively reviewed. Surviving patients voluntarily participated in a clinical history and physical examination that focused on neurological function and current tumor status.
  
  
  RESULTS
  Follow-up data are 100% complete; median follow-up time was 6.1 years. All patients (100%) had surgery as the first line of treatment; gross total resection was performed in 112 patients (85.5%) and subtotal resection in 19 patients (14.5%). Five-year progression-free survival was 89%. The following risk factors for recurrence were identified: neurofibroma, malignant peripheral nerve sheath tumor, subtotal resection, neurofibromatoses/schwannomatosis, and advancing age at diagnosis. More than 95% of patients had neurological function compatible with an independent life at follow-up. The rate of tumor recurrence in nonneurofibromatosis patients undergoing total resection of a single schwannoma was 3% (3/93), in comparison with a recurrence rate of 32% (12/38) in the remaining patients.
  
  
  CONCLUSIONS
  Gross total resection is the gold standard treatment for patients with intraspinal nerve sheath tumors. In a time of limited health care resources, we recommend that follow-up be focused on the subgroup of patients with a high risk of recurrence. The benefit of long-term, yearly magnetic resonance imaging follow-up with respect to recurrence in nonneurofibromatosis patients undergoing gross total resection of a single schwannoma is, in our opinion, questionable. 1NF2, neurofibromatosis 2NST, nerve sheath tumorOS, overall survivalPFS, progression-free survivalSTR, subtotal resectionWHO, World Health Organization.
authors.affiliation: *Faculty of Medicine, University of Oslo, Oslo, Norway; ‡Departments of Neurosurgery and §Radiology, Oslo University Hospital, Oslo, Norway; ¶The Norwegian Cancer Registry, Oslo, Norway.
authors.forename: Charlotte Marie
authors.initials: CM
authors.lastname: Halvorsen
authors.forename: Pål
authors.initials: P
authors.lastname: Rønning
authors.forename: John
authors.initials: J
authors.lastname: Hald
authors.forename: Tom Børge
authors.initials: TB
authors.lastname: Johannesen
authors.forename: Frode
authors.initials: F
authors.lastname: Kolstad
authors.forename: Iver A
authors.initials: IA
authors.lastname: Langmoen
authors.forename: Bjarne
authors.initials: B
authors.lastname: Lied
authors.forename: Sigrun
authors.initials: S
authors.lastname: Skaar Holme
authors.forename: Eirik
authors.initials: E
authors.lastname: Helseth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D018317:Nerve Sheath Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D013127:Spinal Nerves / Q000473:pathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult