Systematic Review and Individual Patient data in Lipoid Neurocytoma - Impact of Radiotherapy
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Abstract
Systematic Review and Individual Patient data in Lipoid Neurocytoma - Impact of Radiotherapy
Authors: Jhansi Pattanaik1, Vibhay Pareek2, Mansi Barthwal2, Soham Sanyal1, Sudatta Mandal1, Danda Vamsi Sai Praveen1, Suyash Pandey1, Gopikrishna Shyam1, Manvendra Singh Tanwar1, Devangana Bora1, Sai Kumar Samala1, Sushant Nirala1, Adila A1, Vivek Ghosh1, Aswin Ravi1, Ajit Priy Solanki1, Rahul Sisodiya3, Daya Nand Sharma1, Subhash Gupta1, Haresh K P1
1IRCH, AIIMS, Radiation Oncology, New Delhi, India; 2National Cancer Institute, AIIMS, Radiation Oncology, New Delhi, India; 3IRCH, AIIMS, Radiation Oncology, New Delhi, India
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Purpose or Objective
Liponeurocytoma develops mainly in adult patients within the posterior fossa and it has been
categorized as a benign grade II tumor. It is characterized by the presence of neuronal and variable
astrocytic differentiation with foci of lipomatous distinction. The rarity has led to no consensus guidelines
for the management and thus, the aim of this study was to analyze the literature to create treatment
guidelines.
Material and Methods
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to
search existing online databases between January 1, 1990 and December 31, 2020. A systematic search on
PubMed and Google scholar was done and an individual patient data analysis was carried out.
Results
A systematic review and individual patient data analysis of the literature found 103 patients (73
male, 30 female) with liponeurocytoma with most common site of presentation being the posterior fossa
(86.1%). The mean Ki-67/MIB-1 proliferation index was 3.56%. After a median follow-up of 58 months, the
tumor recurrence rate was 18.9% among the patient cohort. Tumor recurrence was found to be significantly
higher among those who did not receive Radiation therapy (p<0.001). Complete Tumor resection was seen in
70.5% and tumor recurrence was after median of 72.5 months favouring the addition of post operative
radiation therapy especially in incomplete resection (p=0.012).
Conclusion
Liponeurocytomas are rare benign tumors, occurring mainly in the cerebellum. The therapy of choice is
surgery. Postoperative radiotherapy seems to decrease the risk of tumor recurrence and should be offered to
the patient.