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J Neurol Surg B Skull Base 2018; 79(04): 319-324
DOI: 10.1055/s-0037-1607421
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Growth Patterns of Residual Tumor in Preoperatively Growing Vestibular Schwannomas

Anand V. Kasbekar
1   Department of Otorhinolaryngology, Head & Neck Surgery, Nottingham University Hospitals, Nottingham, United Kingdom
,
Guleed H. Adan
2   Department of Otolaryngology, Head & Neck Surgery, Aintree University Hospitals, Liverpool, United Kingdom
,
Alaina Beacall
2   Department of Otolaryngology, Head & Neck Surgery, Aintree University Hospitals, Liverpool, United Kingdom
,
Ahmed M. Youssef
2   Department of Otolaryngology, Head & Neck Surgery, Aintree University Hospitals, Liverpool, United Kingdom
3   Department of ENT, Ain Shams University, Cairo, Egypt
,
Catherine E. Gilkes
4   Department of Neurosurgery, The Walton Centre, Liverpool, United Kingdom
,
Tristram H. Lesser
2   Department of Otolaryngology, Head & Neck Surgery, Aintree University Hospitals, Liverpool, United Kingdom
› Author Affiliations Funding This research received no specific grant from any funding agency or commercial or not-for-profit sectors.
Further Information

Publication History

03 February 2017

15 September 2017

Publication Date:
08 November 2017 (online)

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Abstract

Objectives To analyze growth of residual vestibular schwannoma (VS) following incomplete tumor resection and determine the influence of residual location and size.

Design Retrospective case note and scan review.

Setting Tertiary skull base unit.

Participants Patients with residual tumor following primary surgery for medium and large unilateral growing vestibular schwanomas between 2006 and 2009.

Main Outcome Measures Location of residual VS and post-operative growth, comparing those with more (>5%) or less than 5% of tumor residual (<5%).

Results Fifty-two patients had visible residual tumor left behind at surgery. Twenty had < 5% and 32 had > 5% residual. The residual growth rates were 38% overall, 20% in < 5%, and 50% in > 5% residuals. There was no significant difference in growth rates at different residual locations. Median follow-up was 6.4 years.

Conclusions There is a greater risk of regrowth of residuals > 5%. All positions of residual tumor can regrow, and the preoperative tumor size plays a role in this. Further data is needed to confirm if residual tumor in the fundus is less likely to grow.

Keywords

vestibular schwannoma - residual tumor - tumor regrowth

Note

This article was presented orally at the British Skull Base Society Meeting, January 29–30, 2015, Dublin, Ireland.


 

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