• Charlotte Marie Halvorsen, Pål Rønning, John Hald, Tom Børge Johannesen, Frode Kolstad, Iver A Langmoen, Bjarne Lied, Sigrun Skaar Holme, and Eirik Helseth.
• *Faculty of Medicine, University of Oslo, Oslo, Norway; ‡Departments of Neurosurgery and §Radiology, Oslo University Hospital, Oslo, Norway; ¶The Norwegian Cancer Registry, Oslo, Norway.
• Neurosurgery. 2015 Oct 1; 77 (4): 585-92; discussion 592-3.

BackgroundThe existing literature on recurrence rates and long-term clinical outcome after resection of intraspinal nerve sheath tumors is limited.ObjectiveTo evaluate progression-free survival, overall survival, and long-term clinical outcome in a consecutive series of 131 patients with symptomatic intraspinal nerve sheath tumors.MethodsMedical charts were retrospectively reviewed. Surviving patients voluntarily participated in a clinical history and physical examination that focused on neurological function and current tumor status.ResultsFollow-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.ConclusionGross 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.

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