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Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review
Background: Craniovertebral junction (CVJ) schwannomas are rare, with surgery and stereotactic radiosurgery (SRS) being effective yet challenging options. We systematically reviewed the literature on CVJ schwannomas. Methods: PubMed, Scopus, Web-of-Science, and Cochrane were searched following the P...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9319499/ https://www.ncbi.nlm.nih.gov/pubmed/35877244 http://dx.doi.org/10.3390/curroncol29070384 |
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author | Palmisciano, Paolo Ferini, Gianluca Watanabe, Gina Conching, Andie Ogasawara, Christian Scalia, Gianluca Bin-Alamer, Othman Haider, Ali S. Passanisi, Maurizio Maugeri, Rosario Hoz, Samer S. Baldoncini, Matias Campero, Alvaro Salvati, Maurizio Cohen-Gadol, Aaron A. Umana, Giuseppe E. |
author_facet | Palmisciano, Paolo Ferini, Gianluca Watanabe, Gina Conching, Andie Ogasawara, Christian Scalia, Gianluca Bin-Alamer, Othman Haider, Ali S. Passanisi, Maurizio Maugeri, Rosario Hoz, Samer S. Baldoncini, Matias Campero, Alvaro Salvati, Maurizio Cohen-Gadol, Aaron A. Umana, Giuseppe E. |
author_sort | Palmisciano, Paolo |
collection | PubMed |
description | Background: Craniovertebral junction (CVJ) schwannomas are rare, with surgery and stereotactic radiosurgery (SRS) being effective yet challenging options. We systematically reviewed the literature on CVJ schwannomas. Methods: PubMed, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA statement to include studies reporting CVJ schwannomas. Clinical features, management, and outcomes were analyzed. Results: We collected 353 patients from 101 included articles. Presenting symptoms were mostly neck pain (30.3%) and headache (26.3%), with most cranial neuropathies involving the XII (31.2%) and X (24.4%) nerves. Most tumors originated from C2 (30.9%) and XII (29.4%) nerves, being extracranial (45.1%) and intradural-extradural (44.2%). Erosion of C1–C2 vertebrae (37.1%), the hypoglossal canal (28.3%), and/or jugular foramen (20.1%) were noted. All tumors were operated, preferably with the retrosigmoid approach (36.5%), with the far-lateral approach (29.7%) or with the posterior approach and cervical laminectomy (26.9%), far-lateral approaches (14.2%), or suboccipital craniotomy with concurrent cervical laminectomy (14.2%). Complete tumor resection was obtained most frequently (61.5%). Adjuvant post-surgery stereotactic radiosurgery was delivered in 5.9% patients. Median follow-up was 27 months (range, 12–252). Symptom improvement was noted in 88.1% of cases, and cranial neuropathies showed improvement in 10.2%. Post-surgical complications occurred in 83 patients (23.5%), mostly dysphagia (7.4%), new cranial neuropathies (6.2%), and cerebrospinal fluid leak (5.9%). A total of 16 patients (4.5%) had tumor recurrence and 7 died (2%), with median overall survival of 2.7 months (range, 0.1–252). Conclusions: Microsurgical resection is safe and effective for CVJ schwannomas. Data on SRS efficacy and indications are still lacking, and its role deserves further evaluation. |
format | Online Article Text |
id | pubmed-9319499 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93194992022-07-27 Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review Palmisciano, Paolo Ferini, Gianluca Watanabe, Gina Conching, Andie Ogasawara, Christian Scalia, Gianluca Bin-Alamer, Othman Haider, Ali S. Passanisi, Maurizio Maugeri, Rosario Hoz, Samer S. Baldoncini, Matias Campero, Alvaro Salvati, Maurizio Cohen-Gadol, Aaron A. Umana, Giuseppe E. Curr Oncol Systematic Review Background: Craniovertebral junction (CVJ) schwannomas are rare, with surgery and stereotactic radiosurgery (SRS) being effective yet challenging options. We systematically reviewed the literature on CVJ schwannomas. Methods: PubMed, Scopus, Web-of-Science, and Cochrane were searched following the PRISMA statement to include studies reporting CVJ schwannomas. Clinical features, management, and outcomes were analyzed. Results: We collected 353 patients from 101 included articles. Presenting symptoms were mostly neck pain (30.3%) and headache (26.3%), with most cranial neuropathies involving the XII (31.2%) and X (24.4%) nerves. Most tumors originated from C2 (30.9%) and XII (29.4%) nerves, being extracranial (45.1%) and intradural-extradural (44.2%). Erosion of C1–C2 vertebrae (37.1%), the hypoglossal canal (28.3%), and/or jugular foramen (20.1%) were noted. All tumors were operated, preferably with the retrosigmoid approach (36.5%), with the far-lateral approach (29.7%) or with the posterior approach and cervical laminectomy (26.9%), far-lateral approaches (14.2%), or suboccipital craniotomy with concurrent cervical laminectomy (14.2%). Complete tumor resection was obtained most frequently (61.5%). Adjuvant post-surgery stereotactic radiosurgery was delivered in 5.9% patients. Median follow-up was 27 months (range, 12–252). Symptom improvement was noted in 88.1% of cases, and cranial neuropathies showed improvement in 10.2%. Post-surgical complications occurred in 83 patients (23.5%), mostly dysphagia (7.4%), new cranial neuropathies (6.2%), and cerebrospinal fluid leak (5.9%). A total of 16 patients (4.5%) had tumor recurrence and 7 died (2%), with median overall survival of 2.7 months (range, 0.1–252). Conclusions: Microsurgical resection is safe and effective for CVJ schwannomas. Data on SRS efficacy and indications are still lacking, and its role deserves further evaluation. MDPI 2022-07-09 /pmc/articles/PMC9319499/ /pubmed/35877244 http://dx.doi.org/10.3390/curroncol29070384 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Systematic Review Palmisciano, Paolo Ferini, Gianluca Watanabe, Gina Conching, Andie Ogasawara, Christian Scalia, Gianluca Bin-Alamer, Othman Haider, Ali S. Passanisi, Maurizio Maugeri, Rosario Hoz, Samer S. Baldoncini, Matias Campero, Alvaro Salvati, Maurizio Cohen-Gadol, Aaron A. Umana, Giuseppe E. Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review |
title | Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review |
title_full | Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review |
title_fullStr | Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review |
title_full_unstemmed | Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review |
title_short | Surgical Management of Craniovertebral Junction Schwannomas: A Systematic Review |
title_sort | surgical management of craniovertebral junction schwannomas: a systematic review |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9319499/ https://www.ncbi.nlm.nih.gov/pubmed/35877244 http://dx.doi.org/10.3390/curroncol29070384 |
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