Peripheral nerve tumors (PNT) are a heterogeneous subgroup of soft tissue tumors in association with peripheral nerves and are rare diseases. Clinical presentation can be versatile and include stress and rest pain, sensory and motoric deficits, or they can be found as incidental findings on imaging without any symptoms.

In total, the PNTR contains up-to-date data of 290 surgical treated patients from three high-volume centers. Patient characteristics (age, sex) as well as disease (affected nerve, tumor location, histopathology), surgical treatment (type of treatment, pre-and postoperative symptoms), radiological imaging, diagnosis of neurofibromatosis (NF), and long-term follow-up data including life quality data using a standardized questionnaire (EQ-5D-5L) were analyzed. In this sub-study, the effect of surgery on pain in patients with PNT was analyzed.

In total data of 290 patients were included with schwannoma (58.6 %, n= 170) and neurofibroma (17.2 %, n=50) being the most prevalent histopathological diagnoses. Upper extremity was affected in 158 cases (54.4 %) whereas lower extremity was affected in 132 cases (45.5 %). Plexus brachialis was in 16.8 % (n= 49) the most affected nerval structure. Patients were treated by complete tumor resection (n=245) in 84.1 %, biopsy in (n=27) 9.3 %, and partial tumor removal in (n=18) 6.2 %. 24 patients (8.2 %) were genetically proven with neurofibromatosis 1, 2, or schwannomatosis.

Prevailing preoperative clinical symptoms were pain during stress in 206 (71 %) and rest pain in 109 (37.5 %) patients. After surgery, patients benefited from highly reduced pain, only in 80 patients (27.5 %) pain was still present. These results are confirmed by a subgroup analysis of 171 patients analyzing their quality of life using the EQ-5D-5L questionnaire. In the domain of pain, the overall cohort benefited significantly from surgery (p<0.001).

In our cohort rest and stress pain were at initial diagnosis the most common clinical symptoms- not only in malignant tumors but also in benign PNT. The dimension of pain predominantly affected the overall life quality and was significantly improved by surgery. In summary, surgical therapy led to excellent pain relief.