Vestibular schwannoma: natural growth and possible predictive factors

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。

Keywords:

• Acoustic neuroma
• vestibular schwannoma
• growth
• prediction

Disclosure statement

No potential conflict of interest was reported by the authors.