Skull Base 2003; 13(4): 247-249
DOI: 10.1055/s-2004-817702
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

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Publication Date:
03 February 2004 (online)

DIAGNOSIS

A. Mohyuddin, E.A. Vokurka, D.G.R. Evans, R.T. Ramsden, A. Jackson. Is clinical growth index a reliable predictor of tumor growth in vestibular schwannomas? Clin Otolaryngol 2003;28:85-90

We have assessed the clinical growth index as an indicator of tumor growth rate in 50 patients with a vestibular schwannoma. Clinical growth index was calculated by measuring the length of history and dividing it by the maximum tumor diameter. Total tumor volumes were also measured from all MRI examinations and an effective tumor volume doubling time was calculated. Radiological growth measurements demonstrated involution in 10/50 patients. The median volume doubling time was 1.65 years (range 20.9-46.3 months, skewness 1.72 years). The median clinical growth index was 0.030 cm per month (range 0-0.270 cm per month, skewness 2.398). There was no significant correlation between volume doubling time and clinical growth index. Identification of rapidly growing tumors with clinical growth index > 0.025 cm/month had a positive predictive value of 61%, negative predictive value of 48%, false-positive rate of 30% and false-negative rate of 52%. In conclusion, we have shown that the growth rate of vestibular schwannoma is not related to the clinical growth index and we recommend that this measure should be abandoned in the clinical management of patients, where conservative management regimes are being considered.

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