Epidemiology and Long-Term Treatment Outcome of Central Neurocytoma: A Retrospective National Study from Saudi Arabia.
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OBJECTIVE: To describe the clinical features, management, and long-term outcomes of central neurocytoma (CNC). METHODS: A retrospective cohort included all histopathologically confirmed CNC cases treated at 11 tertiary centers in Saudi Arabia from 1996 to 2021. Overall survival (OS) and progression-free survival (PFS) were estimated with Kaplan-Meier and compared with the log-rank test. Postoperative radiation was modeled as a time-dependent exposure to address immortal time bias. Functional outcomes were assessed with the modified Rankin Scale. RESULTS: A total of 104 patients were identified (mean age 26.9 years, 51.9% male), corresponding to an annual incidence of 14.4 cases per 100 million persons. Most tumors were intraventricular (92.2%). Gross total resection was achieved in 41.3%, subtotal resection in 55.8%, and biopsy only in 2.9%. Postoperative radiation was performed in 40% of cases, with a median interval of 98 days after surgery. The 5-year and 10-year OS were 91.7% and 88.9%, respectively, and PFS were 80.1% and 69.4%, respectively. Neither extent of resection nor postoperative radiation was significantly associated with OS or PFS. Tumors larger than 36.3 cm3 were associated with poorer OS (P = 0.018) and functional outcomes (P = 0.002). At last follow-up, 81.7% of patients maintained functional independence (modified Rankin Scale ≤ 2). CONCLUSIONS: CNC offers favorable long-term survival and functional outcomes. Maximal safe resection remains the mainstay of treatment, while the benefit of postoperative radiation appears limited. Tumor size remains a key determinant of outcome.