Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Natural History of Growing Sporadic Vestibular Schwannomas During Observation: An International Multi-Institutional Study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Vestibular Function in Pendred Syndrome: Intact High Frequency VOR and Saccular Hypersensitivity

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. OpenEar Image Data Enables Case Variation in High Fidelity Virtual Reality Ear Surgery

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Objective Vestibular Test Battery and Patient Reported Outcomes in Cochlear Implant Recipients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Vestibular Screening Before Cochlear Implantation: Clinical Implications and Challenges in 409 Cochlear Implant Recipients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Vestibular Function in Pendred Syndrome: Intact High Frequency VOR and Saccular Hypersensitivity

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Long-Term Vestibular Outcomes in Cochlear Implant Recipients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. COVID-19 infection rate among tertiary referral center otorhinolaryngology healthcare workers

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVE: Active treatment of small- or medium-sized vestibular schwannoma during wait-and-scan management is currently recommended at most centers globally once growth is detected. The primary aim of the current study was to characterize the natural history of growing sporadic vestibular schwannoma during observation.

STUDY DESIGN: Cohort study.

SETTING: Four tertiary referral centers across the United States and Denmark.

PATIENTS: Patients with two prior MRI scans demonstrating ≥2 mm of linear growth who continued observational management.

INTERVENTION: Observation with serial imaging.

MAIN OUTCOME MEASURE: Subsequent linear growth-free survival (i.e., an additional ≥2 mm of growth) following initial growth of ≥2 mm from tumor size at diagnosis.

RESULTS: Among 3,402 patients undergoing observation, 592 met inclusion criteria. Median age at initial growth was 66 years (IQR 59-73) for intracanalicular tumors (N = 65) and 62 years (IQR 54-70) for tumors with cerebellopontine angle extension (N = 527). The median duration of MRI surveillance following initial detection of tumor growth was 5.2 years (IQR 2.4-6.9) for intracanalicular tumors and 1.0 year (IQR 1.0-3.3) for cerebellopontine angle tumors. For intracanalicular tumors, subsequent growth-free survival rates (95% CI; number still at risk) at 1, 2, 3, 4, and 5 years following the initial MRI that demonstrated growth were 77% (67-88; 49), 53% (42-67; 31), 46% (35-60; 23), 34% (24-49; 17), and 32% (22-47; 13), respectively. For cerebellopontine angle tumors, subsequent growth-free survival rates were 72% (68-76; 450), 47% (42-52; 258), 32% (28-38; 139), 26% (21-31; 82), and 22% (18-28; 57), respectively. For every 1 mm increase in magnitude of growth from diagnosis to tumor size at detection of initial growth, the HRs associated with subsequent growth were 1.64 (95% CI 1.25-2.15; p < 0.001) for intracanalicular tumors and 1.08 (95% CI 1.01-1.15; p = 0.02) for cerebellopontine angle tumors.

CONCLUSIONS: Growth detected during observation does not necessarily portend future growth, especially for slowly growing tumors. Because early treatment does not confer improved long-term quality of life outcomes, toleration of some growth during observation is justifiable in appropriately selected cases.

OriginalsprogEngelsk
TidsskriftOtology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
Vol/bind42
Udgave nummer8
Sider (fra-til)e1118-e1124
ISSN1531-7129
DOI
StatusUdgivet - 1 sep. 2021

Bibliografisk note

Copyright © 2021, Otology & Neurotology, Inc.

ID: 67832459