Scoring System Assessing Risks of Growth in Sporadic Vestibular Schwannoma.
Journal
Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914
Informations de publication
Date de publication:
11 Oct 2024
11 Oct 2024
Historique:
received:
26
06
2022
accepted:
28
06
2024
medline:
29
10
2024
pubmed:
29
10
2024
entrez:
29
10
2024
Statut:
aheadofprint
Résumé
Surveillance studies offer sparse knowledge of predictors of future growth in sporadic vestibular schwannomas (VS).Our aim was identification of these risk factors. We propose a scoring system to estimate the risk of growth in sporadic vestibular schwannoma. This retrospective study is based on the demographic and radiological data of 615 adult patients under the surveillance for single VS in our center. Univariate analysis, multivariate regression, and Kaplan-Meier analysis were used when appropriate. The regression coefficient-based "VS score" was calculated based on Cox proportional-hazards regression. During surveillance, 285 tumors (46%) remained stable, 314 tumors (51%) grew, and 16 tumors (3%) shrank. The significant risks factors for future growth identified both in univariate and multivariate analyses were younger age at onset, cystic morphology, larger tumor volume, and cisternal location (as per Hannover grade). The proportion of growing tumors was 40%, 75%, and 96% among the homogeneous VS, primary cystic, and VS transformed to cystic, respectively. Moreover, tumor growth during the 1st year was significant predictor of continuous growth. Our "VS score" includes variables such as age, sex, morphology, and Hannover grade. The score extends between -3 and 6 points. Kaplan-Meier, confusion matrix, and receiver operating characteristic analysis proved high accuracy of our scoring model. Our retrospective study revealed that younger age, cystic morphology, cisternal extent, larger volume, and growth during 1st year were strong predictors of future growth. Moreover, we propose a scoring system that accurately estimates the risks of future tumor growth.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Surveillance studies offer sparse knowledge of predictors of future growth in sporadic vestibular schwannomas (VS).Our aim was identification of these risk factors. We propose a scoring system to estimate the risk of growth in sporadic vestibular schwannoma.
METHODS
METHODS
This retrospective study is based on the demographic and radiological data of 615 adult patients under the surveillance for single VS in our center. Univariate analysis, multivariate regression, and Kaplan-Meier analysis were used when appropriate. The regression coefficient-based "VS score" was calculated based on Cox proportional-hazards regression.
RESULTS
RESULTS
During surveillance, 285 tumors (46%) remained stable, 314 tumors (51%) grew, and 16 tumors (3%) shrank. The significant risks factors for future growth identified both in univariate and multivariate analyses were younger age at onset, cystic morphology, larger tumor volume, and cisternal location (as per Hannover grade). The proportion of growing tumors was 40%, 75%, and 96% among the homogeneous VS, primary cystic, and VS transformed to cystic, respectively. Moreover, tumor growth during the 1st year was significant predictor of continuous growth. Our "VS score" includes variables such as age, sex, morphology, and Hannover grade. The score extends between -3 and 6 points. Kaplan-Meier, confusion matrix, and receiver operating characteristic analysis proved high accuracy of our scoring model.
CONCLUSION
CONCLUSIONS
Our retrospective study revealed that younger age, cystic morphology, cisternal extent, larger volume, and growth during 1st year were strong predictors of future growth. Moreover, we propose a scoring system that accurately estimates the risks of future tumor growth.
Identifiants
pubmed: 39471095
doi: 10.1227/neu.0000000000003170
pii: 00006123-990000000-01388
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © Congress of Neurological Surgeons 2024. All rights reserved.
Références
Goldbrunner R, Weller M, Regis J, et al. EANO guideline on the diagnosis and treatment of vestibular schwannoma. Neuro Oncol. 2020;22(1):31-45.
Kshettry VR, Hsieh JK, Ostrom QT, Kruchko C, Barnholtz-Sloan JS. Incidence of vestibular schwannomas in the United States. J Neurooncol. 2015;124(2):223-228.
Khrais T, Romano G, Sanna M. Nerve origin of vestibular schwannoma: a prospective study. J Laryngol Otol. 2008;122(2):128-131.
Paldor I, Chen AS, Kaye AH. Growth rate of vestibular schwannoma. J Clin Neurosci. 2016;32:1-8.
Schnurman Z, Nakamura A, McQuinn MW, Golfinos JG, Roland JT, Kondziolka D. Volumetric growth rates of untreated vestibular schwannomas. J Neurosurg. 2019;133(3):742-748.
Marinelli JP, Schnurman Z, Killeen DE, et al. Long-term natural history and patterns of sporadic vestibular schwannoma growth: a multi-institutional volumetric analysis of 952 patients. Neuro Oncol. 2022;24(8):1298-1306.
Fieux M, Pouzet C, Bonjour M, Zaouche S, Jouanneau E, Tringali S. MRI monitoring of small and medium-sized vestibular schwannomas: predictors of growth. Acta Otolaryngol. 2020;140(5):361-365.
Kleijwegt M, Bettink F, Malessy M, Putter H, van der Mey A. Clinical predictors leading to change of initial conservative treatment of 836 vestibular schwannomas. J Neurol Surg B Skull Base. 2020;81(1):15-21.
D'Haese S, Parmentier H, Keppler H, et al. Vestibular schwannoma: natural growth and possible predictive factors. Acta Otolaryngol. 2019;139(9):753-758.
Lewis D, Roncaroli F, Agushi E, et al. Inflammation and vascular permeability correlate with growth in sporadic vestibular schwannoma. Neuro Oncol. 2019;21(3):314-325.
Borsetto D, Gair J, Kenyon O, et al. When should we stop scanning older patients with vestibular schwannomas? J Neurol Surg B Skull Base. 2019;80(4):333-337.
Joo JD, Oh SJ, Kim YH, et al. Prognostic factors of hearing outcome in untreated vestibular schwannomas: implication of subdivision of their growth by volumetric analysis. World Neurosurg. 2017;106:768-774.
Younes E, Montava M, Bachelard-Serra M, Jaloux L, Salburgo F, Lavieille JP. Intracanalicular vestibular schwannomas: initial clinical manifestation, imaging classification, and risk stratification for management proposal. Otol Neurotol. 2017;38(9):1345-1350.
Daultrey CR, Rainsbury JW, Irving RM. Size as a risk factor for growth in conservatively managed vestibular schwannomas: the Birmingham experience. Otolaryngol Clin North Am. 2016;49(5):1291-1295.
Hunter JB, Francis DO, O'Connell BP, et al. Single institutional experience with observing 564 vestibular schwannomas: factors associated with tumor growth. Otol Neurotol. 2016;37(10):1630-1636.
van Linge A, Borsboom GJ, Wieringa MH, Goedegebure A. Hearing loss progresses faster in patients with growing intracanalicular vestibular schwannomas. Otol Neurotol. 2016;37(9):1442-1448.
Tomita Y, Tosaka M, Aihara M, Horiguchi K, Yoshimoto Y. Growth of primary and remnant vestibular schwannomas: a three-year follow-up study. World Neurosurg. 2015;83(6):937-944.
Patnaik U, Prasad SC, Tutar H, Giannuzzi AL, Russo A, Sanna M. The long-term outcomes of wait-and-scan and the role of radiotherapy in the management of vestibular schwannomas. Otol Neurotol. 2015;36(4):638-646.
Fayad JN, Semaan MT, Lin J, Berliner KI, Brackmann DE. Conservative management of vestibular schwannoma: expectations based on the length of the observation period. Otol Neurotol. 2014;35(7):1258-1265.
Tang S, Griffin AS, Waksal JA, et al. Surveillance after resection of vestibular schwannoma: measurement techniques and predictors of growth. Otol Neurotol. 2014;35(7):1271-1276.
Moffat DA, Kasbekar A, Axon PR, Lloyd SK. Growth characteristics of vestibular schwannomas. Otol Neurotol. 2012;33(6):1053-1058.
Varughese JK, Breivik CN, Wentzel-Larsen T, Lund-Johansen M. Growth of untreated vestibular schwannoma: a prospective study. J Neurosurg. 2012;116(4):706-712.
Eljamel S, Hussain M, Eljamel MS. Should initial surveillance of vestibular schwannoma be abandoned? Skull Base. 2011;21(1):59-64.
Hughes M, Skilbeck C, Saeed S, Bradford R. Expectant management of vestibular schwannoma: a retrospective multivariate analysis of tumor growth and outcome. Skull Base. 2011;21(5):295-302.
van de Langenberg R, de Bondt BJ, Nelemans PJ, Dohmen AJ, Baumert BG, Stokroos RJ. Predictors of volumetric growth and auditory deterioration in vestibular schwannomas followed in a wait and scan policy. Otol Neurotol. 2011;32(2):338-344.
Agrawal Y, Clark JH, Limb CJ, Niparko JK, Francis HW. Predictors of vestibular schwannoma growth and clinical implications. Otol Neurotol. 2010;31(5):807-812.
Bakkouri WE, Kania RE, Guichard JP, Lot G, Herman P, Huy PT. Conservative management of 386 cases of unilateral vestibular schwannoma: tumor growth and consequences for treatment. J Neurosurg. 2009;110(4):662-669.
Hajioff D, Raut VV, Walsh RM, et al. Conservative management of vestibular schwannomas: third review of a 10-year prospective study. Clin Otolaryngol. 2008;33(3):255-259.
Solares CA, Panizza B. Vestibular schwannoma: an understanding of growth should influence management decisions. Otol Neurotol. 2008;29(6):829-834.
Roehm PC, Gantz BJ. Management of acoustic neuromas in patients 65 years or older. Otol Neurotol. 2007;28(5):708-714.
Battaglia A, Mastrodimos B, Cueva R. Comparison of growth patterns of acoustic neuromas with and without radiosurgery. Otol Neurotol. 2006;27(5):705-712.
Stangerup SE, Caye-Thomasen P, Tos M, Thomsen J. The natural history of vestibular schwannoma. Otol Neurotol. 2006;27(4):547-552.
Bozorg Grayeli A, Kalamarides M, Ferrary E, et al. Conservative management versus surgery for small vestibular schwannomas. Acta Otolaryngol. 2005;125(10):1063-1068.
Sakamoto T, Fukuda S, Inuyama Y. Hearing loss and growth rate of acoustic neuromas in follow-up observation policy. Auris Nasus Larynx. 2001;28(Suppl):S23-S27.
Tschudi DC, Linder TE, Fisch U. Conservative management of unilateral acoustic neuromas. Am J Otol. 2000;21(5):722-728.
Sethi M, Borsetto D, Bance M, et al. Determinants of vestibular schwannoma growth. Otol Neurotol. 2021;42(5):746-754.
Stastna D, Mannion R, Axon P, et al. Facial nerve function outcome and risk factors in resection of large cystic vestibular schwannomas. J Neurol Surg B Skull Base. 2022;83(Suppl 2):e216-e224.
Charabi S, Tos M, Børgesen SE, Thomsen J. Cystic acoustic neuromas. Results of translabyrinthine surgery. Arch Otolaryngol Head Neck Surg. 1994;120(12):1333-1338.
Piccirillo E, Wiet MR, Flanagan S, et al. Cystic vestibular schwannoma: classification, management, and facial nerve outcomes. Otol Neurotol. 2009;30(6):826-834.
Falcioni M, Taibah A, De Donato G, Piccirillo E, Russo A, Sanna M. Fast-growing vestibular schwannoma. Skull Base Surg. 2000;10(2):95-99.
Håvik AL, Bruland O, Myrseth E, et al. Genetic landscape of sporadic vestibular schwannoma. J Neurosurg. 2018;128(3):911-922.
Li KL, Djoukhadar I, Zhu X, et al. Vascular biomarkers derived from dynamic contrast-enhanced MRI predict response of vestibular schwannoma to antiangiogenic therapy in type 2 neurofibromatosis. Neuro Oncol. 2016;18(2):275-282.
Reznitsky M, Petersen MMBS, West N, Stangerup SE, Cayé-Thomasen P. The natural history of vestibular schwannoma growth-prospective 40-year data from an unselected national cohort. Neuro Oncol. 2021;23(5):827-836.
Lee JD, Kwon TJ, Kim UK, Lee WS. Genetic and epigenetic alterations of the NF2 gene in sporadic vestibular schwannomas. PLoS One. 2012;7(1):e30418.
Kullar PJ, Pearson DM, Malley DS, Collins VP, Ichimura K. CpG island hypermethylation of the neurofibromatosis type 2 (NF2) gene is rare in sporadic vestibular schwannomas. Neuropathol Appl Neurobiol. 2010;36(6):505-514.
Evans DG, Lye R, Neary W, et al. Probability of bilateral disease in people presenting with a unilateral vestibular schwannoma. J Neurol Neurosurg Psychiatry. 1999;66(6):764-767.
Macielak RJ, Patel NS, Lees KA, et al. Delayed tumor growth in vestibular schwannoma: an argument for lifelong surveillance. Otol Neurotol. 2019;40(9):1224-1229.