Abstract
Background: Prediction of vestibular schwannoma (VS) growth would allow for a more differentiated follow-up protocol.
Objectives: The natural course of a VS and predictive factors of growth are investigated.
Methods: Sixty-two sporadic VS cases diagnosed between 2003 and 2015 were included in this retrospective cohort study. After initial surveillance, active therapy was initiated in 31/62 patients. Regular magnetic resonance images (MRIs) were performed. Two mm/year linear difference was the cut-off value for significant growth. The STROBE guidelines have been implemented.
Results: Growth of the tumor was detected in 56% of patients and mainly observed in the first three years of follow-up. Tumor size remained stable in 34% and decreased in 10% of patients. No baseline information, symptom, or sign was found to be predictive for growth.
Conclusions: In 56% of the initially conservatively managed VSs growth was observed and active treatment was initiated. Eighty-seven percent of the growing VSs were identified during the first three years of follow-up. The initially larger VSs seemed to grow faster and needed active treatment earlier during follow-up. No predicting factors for growth identified from the literature could be confirmed in the present study. Serial MRI remains the appropriate method to detect tumor growth.
Chinese abstract
背景:前庭神经鞘瘤(VS)生长的预测使得更分异的随访方案成为可能。
目的:研究VS的自然过程和生长的预测因素。
方法:回顾性队列研究纳入了2003年至2015年间诊断出的62例散发性VS病例。初步监测后, 31名患者开始积极治疗, 接受了常规磁共振图像(MRI)。每年两毫米的线性差异是显著增长的截止值。 STROBE指南已经实施。
结果:56%的患者检测到肿瘤生长, 主要在随访的前三年内观察到。34%的患者肿瘤大小保持稳定, 10%的患者肿瘤变小。没有发现基线信息、症状或体征可预测增长。
结论:在56%最初保守治疗的VS患者中观察到生长并开始积极治疗。在随访的前三年中, 确定了87%的VS生长。最初较大的VS似乎增长得更快, 并且在随访期间需要更早的积极治疗。本研究没有证实文献中认定的生长预测因子。系列MRI仍然是检测肿瘤生长的合适方法。
Disclosure statement
No potential conflict of interest was reported by the authors.