OBJECT: With limited studies available, the correlation between the extent of resection and tumor recurrence in vestibular schwannomas (VSs) has not been definitively established. In this prospective study, the authors evaluated 772 patients who underwent microsurgical resection of VSs to analyze the association between total tumor resection and the tumor recurrence rate. METHODS: The authors selected all cases from a prospectively collected database of patients who underwent microsurgical resection as their initial treatment for a histopathologically confirmed VS. Recurrence-free survival was analyzed using Kaplan-Meier analysis. The authors studied the impact of possible confounders such as patient age and tumor size using stepwise Cox regression to calculate the proportional hazard ratio of recurrence while controlling for other cofounding variables. RESULTS: The authors analyzed data obtained in 571, 89, and 112 patients in whom gross-total, near-total, and subtotal resections, respectively, were performed. A gross-total resection was achieved in 74% of the patients, and the overall recurrence rate in these patients 8.8%. There was no significant relation between the extent of resection and the rate of tumor recurrence (p = 0.58). As expected, the extent of resection was highly correlated with patient age, tumor size, and surgical approach (p < 0.0001). Using Cox regression, the authors found that the approach used did not significantly affect tumor control when the extent of resection was controlled for. CONCLUSIONS: While complete tumor removal is ideal, the results presented here suggest that there is no significant relationship between the extent of resection and tumor recurrence.
OBJECT: With limited studies available, the correlation between the extent of resection and tumor recurrence in vestibular schwannomas (VSs) has not been definitively established. In this prospective study, the authors evaluated 772 patients who underwent microsurgical resection of VSs to analyze the association between total tumor resection and the tumor recurrence rate. METHODS: The authors selected all cases from a prospectively collected database of patients who underwent microsurgical resection as their initial treatment for a histopathologically confirmed VS. Recurrence-free survival was analyzed using Kaplan-Meier analysis. The authors studied the impact of possible confounders such as patient age and tumor size using stepwise Cox regression to calculate the proportional hazard ratio of recurrence while controlling for other cofounding variables. RESULTS: The authors analyzed data obtained in 571, 89, and 112 patients in whom gross-total, near-total, and subtotal resections, respectively, were performed. A gross-total resection was achieved in 74% of the patients, and the overall recurrence rate in these patients 8.8%. There was no significant relation between the extent of resection and the rate of tumor recurrence (p = 0.58). As expected, the extent of resection was highly correlated with patient age, tumor size, and surgical approach (p < 0.0001). Using Cox regression, the authors found that the approach used did not significantly affect tumor control when the extent of resection was controlled for. CONCLUSIONS: While complete tumor removal is ideal, the results presented here suggest that there is no significant relationship between the extent of resection and tumor recurrence.
Authors: Daniela Stastna; Richard Mannion; Patrick Axon; David Andrew Moffat; Neil Donnelly; James R Tysome; David G Hardy; Mahonar Bance; Alexis Joannides; Indu Lawes; Robert Macfarlane Journal: J Neurol Surg B Skull Base Date: 2021-03-01
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Authors: Anand V Kasbekar; Guleed H Adan; Alaina Beacall; Ahmed M Youssef; Catherine E Gilkes; Tristram H Lesser Journal: J Neurol Surg B Skull Base Date: 2017-11-08
Authors: Jagdeep Singh Virk; Sonal Tripathi; Premjit S Randhawa; Elijah A Kwasa; Nigel D Mendoza; Jonathan Harcourt Journal: Indian J Otolaryngol Head Neck Surg Date: 2014-03-25
Authors: Alfred I Neugut; Paul Sackstein; Grace C Hillyer; Judith S Jacobson; Jeffrey Bruce; Andrew B Lassman; Philip A Stieg Journal: Oncologist Date: 2018-10-10
Authors: Scott G Soltys; Michael T Milano; Jinyu Xue; Wolfgang A Tomé; Ellen Yorke; Jason Sheehan; George X Ding; John P Kirkpatrick; Lijun Ma; Arjun Sahgal; Timothy Solberg; John Adler; Jimm Grimm; Issam El Naqa Journal: Int J Radiat Oncol Biol Phys Date: 2020-12-26 Impact factor: 8.013