Loading…
Outcomes of large vestibular schwannomas following subtotal resection: early post-operative volume regression and facial nerve function
Introduction Subtotal resection (STR) of vestibular schwannoma (VS) tumors remains controversial and little is known regarding post-operative volume changes. Methods Authors retrospective reviewed the medical records from January 1st 2002 to January 1st 2018, for all patients who had undergone prima...
Saved in:
| Published in: | Journal of neuro-oncology 2019-06, Vol.143 (2), p.281-288 |
|---|---|
| Main Authors: | , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c441t-ece7bd814032464541240806ebce4fb0845fa246d15e99c45b80ad8fcccb7d323 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c441t-ece7bd814032464541240806ebce4fb0845fa246d15e99c45b80ad8fcccb7d323 |
| container_end_page | 288 |
| container_issue | 2 |
| container_start_page | 281 |
| container_title | Journal of neuro-oncology |
| container_volume | 143 |
| creator | Akinduro, Oluwaseun O. Lundy, Larry B. Quinones-Hinojosa, Alfredo Lu, Victor M. Trifiletti, Daniel M. Gupta, Vivek Wharen, Robert E. |
| description | Introduction
Subtotal resection (STR) of vestibular schwannoma (VS) tumors remains controversial and little is known regarding post-operative volume changes.
Methods
Authors retrospective reviewed the medical records from January 1st 2002 to January 1st 2018, for all patients who had undergone primary STR of large VS at a single tertiary academic institution.
Results
Our series consists of 34 patients with a mean age of 53.9 (median 53; range 21–87) years that had STR of their VS tumor. The mean pre-operative tumor diameter and volume was 3.9 cm (median 3.0 cm; range 1.6–6.0 cm) and 11.7 cm
3
(median 9.6 cm
3
; range 2.8–44.3 cm
3
), respectively, with a mean extent of resection of 86% (median 90%; range 53–99%). The mean radiographic and clinical follow-up was 40 months (range 6–120 months) and 51 months (range 7–141 months), respectively. 85% of patients had optimal House–Brackmann (HB) scores (Grade 1 & 2) immediately post-operatively, and 91% at 1 year; 94% of patients had normal (HB 1) at last follow-up. There was significant regression of residual tumor volume at 1 year (p = 0.006) and 2 years (p = 0.02), but not at 3 years (p = 0.08), when compared to the prior year. There was significant regression of size over time, with a mean slope estimate of − 0.70 units per year (p |
| doi_str_mv | 10.1007/s11060-019-03157-4 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2210271563</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2209790188</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-ece7bd814032464541240806ebce4fb0845fa246d15e99c45b80ad8fcccb7d323</originalsourceid><addsrcrecordid>eNp9kU1rFTEUhoMo9lr9Ay4k4MbN6MkkM5lxJ6V-QKEbBXchkzm5Tskk12TS0l_g3_bYWxVcuDqE87xvEh7Gngt4LQD0myIE9NCAGBuQotONesB2NGWjpZYP2Q5Er5tuVF9P2JNSrgBAaSkesxMJ4zD2rdixH5d1c2nFwpPnweY98mss2zJVOvDivt3YGNNqC_cphHSzxD0vddrSZgPPWNBtS4pvOdocbvkhla1JB8x2W66pKYW6ImF7Igtx3MaZe-sWCkfMhPga7xqeskfehoLP7ucp-_L-_PPZx-bi8sOns3cXjVNKbA061NM8CAWyVb3qlGgVDNDj5FD5CQbVeUubWXQ4jk510wB2HrxzbtKzbOUpe3XsPeT0vdJPzboUhyHYiKkW07YCWi26XhL68h_0KtUc6XVEwahHEMNAVHukXE6lZPTmkJfV5lsjwPzSZI6aDGkyd5qMotCL--o6rTj_ifz2QoA8AoVWcY_5793_qf0JzOqgpQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2209790188</pqid></control><display><type>article</type><title>Outcomes of large vestibular schwannomas following subtotal resection: early post-operative volume regression and facial nerve function</title><source>Springer Link</source><creator>Akinduro, Oluwaseun O. ; Lundy, Larry B. ; Quinones-Hinojosa, Alfredo ; Lu, Victor M. ; Trifiletti, Daniel M. ; Gupta, Vivek ; Wharen, Robert E.</creator><creatorcontrib>Akinduro, Oluwaseun O. ; Lundy, Larry B. ; Quinones-Hinojosa, Alfredo ; Lu, Victor M. ; Trifiletti, Daniel M. ; Gupta, Vivek ; Wharen, Robert E.</creatorcontrib><description>Introduction
Subtotal resection (STR) of vestibular schwannoma (VS) tumors remains controversial and little is known regarding post-operative volume changes.
Methods
Authors retrospective reviewed the medical records from January 1st 2002 to January 1st 2018, for all patients who had undergone primary STR of large VS at a single tertiary academic institution.
Results
Our series consists of 34 patients with a mean age of 53.9 (median 53; range 21–87) years that had STR of their VS tumor. The mean pre-operative tumor diameter and volume was 3.9 cm (median 3.0 cm; range 1.6–6.0 cm) and 11.7 cm
3
(median 9.6 cm
3
; range 2.8–44.3 cm
3
), respectively, with a mean extent of resection of 86% (median 90%; range 53–99%). The mean radiographic and clinical follow-up was 40 months (range 6–120 months) and 51 months (range 7–141 months), respectively. 85% of patients had optimal House–Brackmann (HB) scores (Grade 1 & 2) immediately post-operatively, and 91% at 1 year; 94% of patients had normal (HB 1) at last follow-up. There was significant regression of residual tumor volume at 1 year (p = 0.006) and 2 years (p = 0.02), but not at 3 years (p = 0.08), when compared to the prior year. There was significant regression of size over time, with a mean slope estimate of − 0.70 units per year (p < 0.001).
Conclusion
Excellent clinical facial nerve outcomes can be obtained with STR of large VS tumors. Maximal reduction in tumor size occurs at 2-year post-operatively. Thus, in patients undergoing surgery for large VS, STR and a “watch and wait” strategy is a reasonable treatment option that may optimize facial nerve outcomes.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-019-03157-4</identifier><identifier>PMID: 30989621</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Brain cancer ; Clinical Study ; Facial nerve ; Facial Nerve - physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Medical records ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm, Residual - pathology ; Neoplasm, Residual - surgery ; Neurology ; Neuroma, Acoustic - pathology ; Neuroma, Acoustic - surgery ; Oncology ; Patients ; Postoperative Complications ; Radiosurgery - methods ; Retrospective Studies ; Schwann cells ; Surgery ; Treatment Outcome ; Tumor Burden ; Tumors ; Vestibular system ; Young Adult</subject><ispartof>Journal of neuro-oncology, 2019-06, Vol.143 (2), p.281-288</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Journal of Neuro-Oncology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-ece7bd814032464541240806ebce4fb0845fa246d15e99c45b80ad8fcccb7d323</citedby><cites>FETCH-LOGICAL-c441t-ece7bd814032464541240806ebce4fb0845fa246d15e99c45b80ad8fcccb7d323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30989621$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Akinduro, Oluwaseun O.</creatorcontrib><creatorcontrib>Lundy, Larry B.</creatorcontrib><creatorcontrib>Quinones-Hinojosa, Alfredo</creatorcontrib><creatorcontrib>Lu, Victor M.</creatorcontrib><creatorcontrib>Trifiletti, Daniel M.</creatorcontrib><creatorcontrib>Gupta, Vivek</creatorcontrib><creatorcontrib>Wharen, Robert E.</creatorcontrib><title>Outcomes of large vestibular schwannomas following subtotal resection: early post-operative volume regression and facial nerve function</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Introduction
Subtotal resection (STR) of vestibular schwannoma (VS) tumors remains controversial and little is known regarding post-operative volume changes.
Methods
Authors retrospective reviewed the medical records from January 1st 2002 to January 1st 2018, for all patients who had undergone primary STR of large VS at a single tertiary academic institution.
Results
Our series consists of 34 patients with a mean age of 53.9 (median 53; range 21–87) years that had STR of their VS tumor. The mean pre-operative tumor diameter and volume was 3.9 cm (median 3.0 cm; range 1.6–6.0 cm) and 11.7 cm
3
(median 9.6 cm
3
; range 2.8–44.3 cm
3
), respectively, with a mean extent of resection of 86% (median 90%; range 53–99%). The mean radiographic and clinical follow-up was 40 months (range 6–120 months) and 51 months (range 7–141 months), respectively. 85% of patients had optimal House–Brackmann (HB) scores (Grade 1 & 2) immediately post-operatively, and 91% at 1 year; 94% of patients had normal (HB 1) at last follow-up. There was significant regression of residual tumor volume at 1 year (p = 0.006) and 2 years (p = 0.02), but not at 3 years (p = 0.08), when compared to the prior year. There was significant regression of size over time, with a mean slope estimate of − 0.70 units per year (p < 0.001).
Conclusion
Excellent clinical facial nerve outcomes can be obtained with STR of large VS tumors. Maximal reduction in tumor size occurs at 2-year post-operatively. Thus, in patients undergoing surgery for large VS, STR and a “watch and wait” strategy is a reasonable treatment option that may optimize facial nerve outcomes.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brain cancer</subject><subject>Clinical Study</subject><subject>Facial nerve</subject><subject>Facial Nerve - physiopathology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm, Residual - pathology</subject><subject>Neoplasm, Residual - surgery</subject><subject>Neurology</subject><subject>Neuroma, Acoustic - pathology</subject><subject>Neuroma, Acoustic - surgery</subject><subject>Oncology</subject><subject>Patients</subject><subject>Postoperative Complications</subject><subject>Radiosurgery - methods</subject><subject>Retrospective Studies</subject><subject>Schwann cells</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Tumor Burden</subject><subject>Tumors</subject><subject>Vestibular system</subject><subject>Young Adult</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kU1rFTEUhoMo9lr9Ay4k4MbN6MkkM5lxJ6V-QKEbBXchkzm5Tskk12TS0l_g3_bYWxVcuDqE87xvEh7Gngt4LQD0myIE9NCAGBuQotONesB2NGWjpZYP2Q5Er5tuVF9P2JNSrgBAaSkesxMJ4zD2rdixH5d1c2nFwpPnweY98mss2zJVOvDivt3YGNNqC_cphHSzxD0vddrSZgPPWNBtS4pvOdocbvkhla1JB8x2W66pKYW6ImF7Igtx3MaZe-sWCkfMhPga7xqeskfehoLP7ucp-_L-_PPZx-bi8sOns3cXjVNKbA061NM8CAWyVb3qlGgVDNDj5FD5CQbVeUubWXQ4jk510wB2HrxzbtKzbOUpe3XsPeT0vdJPzboUhyHYiKkW07YCWi26XhL68h_0KtUc6XVEwahHEMNAVHukXE6lZPTmkJfV5lsjwPzSZI6aDGkyd5qMotCL--o6rTj_ifz2QoA8AoVWcY_5793_qf0JzOqgpQ</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Akinduro, Oluwaseun O.</creator><creator>Lundy, Larry B.</creator><creator>Quinones-Hinojosa, Alfredo</creator><creator>Lu, Victor M.</creator><creator>Trifiletti, Daniel M.</creator><creator>Gupta, Vivek</creator><creator>Wharen, Robert E.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20190601</creationdate><title>Outcomes of large vestibular schwannomas following subtotal resection: early post-operative volume regression and facial nerve function</title><author>Akinduro, Oluwaseun O. ; Lundy, Larry B. ; Quinones-Hinojosa, Alfredo ; Lu, Victor M. ; Trifiletti, Daniel M. ; Gupta, Vivek ; Wharen, Robert E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-ece7bd814032464541240806ebce4fb0845fa246d15e99c45b80ad8fcccb7d323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brain cancer</topic><topic>Clinical Study</topic><topic>Facial nerve</topic><topic>Facial Nerve - physiopathology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm, Residual - pathology</topic><topic>Neoplasm, Residual - surgery</topic><topic>Neurology</topic><topic>Neuroma, Acoustic - pathology</topic><topic>Neuroma, Acoustic - surgery</topic><topic>Oncology</topic><topic>Patients</topic><topic>Postoperative Complications</topic><topic>Radiosurgery - methods</topic><topic>Retrospective Studies</topic><topic>Schwann cells</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Tumor Burden</topic><topic>Tumors</topic><topic>Vestibular system</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Akinduro, Oluwaseun O.</creatorcontrib><creatorcontrib>Lundy, Larry B.</creatorcontrib><creatorcontrib>Quinones-Hinojosa, Alfredo</creatorcontrib><creatorcontrib>Lu, Victor M.</creatorcontrib><creatorcontrib>Trifiletti, Daniel M.</creatorcontrib><creatorcontrib>Gupta, Vivek</creatorcontrib><creatorcontrib>Wharen, Robert E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest - Health & Medical Complete保健、医学与药学数据库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuro-oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akinduro, Oluwaseun O.</au><au>Lundy, Larry B.</au><au>Quinones-Hinojosa, Alfredo</au><au>Lu, Victor M.</au><au>Trifiletti, Daniel M.</au><au>Gupta, Vivek</au><au>Wharen, Robert E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of large vestibular schwannomas following subtotal resection: early post-operative volume regression and facial nerve function</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2019-06-01</date><risdate>2019</risdate><volume>143</volume><issue>2</issue><spage>281</spage><epage>288</epage><pages>281-288</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Introduction
Subtotal resection (STR) of vestibular schwannoma (VS) tumors remains controversial and little is known regarding post-operative volume changes.
Methods
Authors retrospective reviewed the medical records from January 1st 2002 to January 1st 2018, for all patients who had undergone primary STR of large VS at a single tertiary academic institution.
Results
Our series consists of 34 patients with a mean age of 53.9 (median 53; range 21–87) years that had STR of their VS tumor. The mean pre-operative tumor diameter and volume was 3.9 cm (median 3.0 cm; range 1.6–6.0 cm) and 11.7 cm
3
(median 9.6 cm
3
; range 2.8–44.3 cm
3
), respectively, with a mean extent of resection of 86% (median 90%; range 53–99%). The mean radiographic and clinical follow-up was 40 months (range 6–120 months) and 51 months (range 7–141 months), respectively. 85% of patients had optimal House–Brackmann (HB) scores (Grade 1 & 2) immediately post-operatively, and 91% at 1 year; 94% of patients had normal (HB 1) at last follow-up. There was significant regression of residual tumor volume at 1 year (p = 0.006) and 2 years (p = 0.02), but not at 3 years (p = 0.08), when compared to the prior year. There was significant regression of size over time, with a mean slope estimate of − 0.70 units per year (p < 0.001).
Conclusion
Excellent clinical facial nerve outcomes can be obtained with STR of large VS tumors. Maximal reduction in tumor size occurs at 2-year post-operatively. Thus, in patients undergoing surgery for large VS, STR and a “watch and wait” strategy is a reasonable treatment option that may optimize facial nerve outcomes.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30989621</pmid><doi>10.1007/s11060-019-03157-4</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-594X |
| ispartof | Journal of neuro-oncology, 2019-06, Vol.143 (2), p.281-288 |
| issn | 0167-594X 1573-7373 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2210271563 |
| source | Springer Link |
| subjects | Adult Aged Aged, 80 and over Brain cancer Clinical Study Facial nerve Facial Nerve - physiopathology Female Follow-Up Studies Humans Male Medical records Medicine Medicine & Public Health Middle Aged Neoplasm, Residual - pathology Neoplasm, Residual - surgery Neurology Neuroma, Acoustic - pathology Neuroma, Acoustic - surgery Oncology Patients Postoperative Complications Radiosurgery - methods Retrospective Studies Schwann cells Surgery Treatment Outcome Tumor Burden Tumors Vestibular system Young Adult |
| title | Outcomes of large vestibular schwannomas following subtotal resection: early post-operative volume regression and facial nerve function |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T06%3A33%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Outcomes%20of%20large%20vestibular%20schwannomas%20following%20subtotal%20resection:%20early%20post-operative%20volume%20regression%20and%20facial%20nerve%20function&rft.jtitle=Journal%20of%20neuro-oncology&rft.au=Akinduro,%20Oluwaseun%20O.&rft.date=2019-06-01&rft.volume=143&rft.issue=2&rft.spage=281&rft.epage=288&rft.pages=281-288&rft.issn=0167-594X&rft.eissn=1573-7373&rft_id=info:doi/10.1007/s11060-019-03157-4&rft_dat=%3Cproquest_cross%3E2209790188%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c441t-ece7bd814032464541240806ebce4fb0845fa246d15e99c45b80ad8fcccb7d323%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2209790188&rft_id=info:pmid/30989621&rfr_iscdi=true |