Evolution in the management of vestibular schwannoma: a single-center 15-year experience
Purpose To highlight the changes in the management of vestibular schwannoma (VS) since 2004 with a focus on small- to middle-size VS. Methods Retrospective analysis of the decisions made in skull base tumor board between 2004 and 2021. Results 1819 decisions were analyzed (average age 59.25, 54% fem...
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| Veröffentlicht in: | European archives of oto-rhino-laryngology 2023-11, Vol.280 (11), p.4885-4894 |
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| creator | El Sayed Ahmad, Youssef Gallois, Yohan Sol, Jean Christophe Boetto, Sergio Attal, Justine Sabatier, Jean Debs, Rachel Deguine, Olivier Marx, Mathieu |
| description | Purpose
To highlight the changes in the management of vestibular schwannoma (VS) since 2004 with a focus on small- to middle-size VS.
Methods
Retrospective analysis of the decisions made in skull base tumor board between 2004 and 2021.
Results
1819 decisions were analyzed (average age 59.25, 54% females). Overall, 850 (47%) cases were allocated to a Wait and Scan (WS) approach, 416 (23%) received radiotherapy and 553 (30%) were treated surgically (MS). All stages considered WS increased from 39% before 2010 to 50% after 2010. Similarly, Stereotactic Radio Therapy (SRT) increased from 5 to 18%. MS decreased from 46 to 25%. It was more commonly proposed to younger patients and larger tumors,
p
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| doi_str_mv | 10.1007/s00405-023-08009-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2814815845</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2814815845</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-c995a996667b7457345d06d801a9ba0f92a7d62f81d3b0d692d6d76ffa627c893</originalsourceid><addsrcrecordid>eNp9kE1P3DAQhi1UxC4Lf4BD5WMvhnH8FXOrEP2QkHopEjfLSSa7WSXO1k4o--9r2KVHTnOY53018xByxeGaA5ibBCBBMSgEgxLAMn1CllwKyaQp9CeyBCsMk9KYBTlPaQsASlpxRhbCcKuEVEvydP889vPUjYF2gU4bpIMPfo0DhomOLX3GNHXV3PtIU73560MYB39LPU1dWPfI6sxhpFyxPWYGX3YYOww1XpDT1vcJL49zRR6_3f---8Eefn3_eff1gdVCmonV1ipvrdbaVEYqk49qQDclcG8rD60tvGl00Za8ERU02haNboxuW68LU5dWrMiXQ-8ujn_mfK0bulRj3_uA45xcUXJZclVKldHigNZxTCli63axG3zcOw7u1ag7GHXZqHsz6nQOfT72z9WAzf_Iu8IMiAOQ8iqsMbrtOMeQf_6o9h82UYDS</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2814815845</pqid></control><display><type>article</type><title>Evolution in the management of vestibular schwannoma: a single-center 15-year experience</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>El Sayed Ahmad, Youssef ; Gallois, Yohan ; Sol, Jean Christophe ; Boetto, Sergio ; Attal, Justine ; Sabatier, Jean ; Debs, Rachel ; Deguine, Olivier ; Marx, Mathieu</creator><creatorcontrib>El Sayed Ahmad, Youssef ; Gallois, Yohan ; Sol, Jean Christophe ; Boetto, Sergio ; Attal, Justine ; Sabatier, Jean ; Debs, Rachel ; Deguine, Olivier ; Marx, Mathieu</creatorcontrib><description>Purpose
To highlight the changes in the management of vestibular schwannoma (VS) since 2004 with a focus on small- to middle-size VS.
Methods
Retrospective analysis of the decisions made in skull base tumor board between 2004 and 2021.
Results
1819 decisions were analyzed (average age 59.25, 54% females). Overall, 850 (47%) cases were allocated to a Wait and Scan (WS) approach, 416 (23%) received radiotherapy and 553 (30%) were treated surgically (MS). All stages considered WS increased from 39% before 2010 to 50% after 2010. Similarly, Stereotactic Radio Therapy (SRT) increased from 5 to 18%. MS decreased from 46 to 25%. It was more commonly proposed to younger patients and larger tumors,
p
< 0.001. For Koos stages 1, 2, and 3 there was a statistically significant increase in SRT, and a decrease in MS,
p
< 0.001. WS also increased for stages 1 and 2. However, such a trend was not observed for stage 3. MS remained the primary treatment modality for stage 4 tumors throughout the study period,
p
= 0.057. The significance of advanced age as a factor favoring SRT decreased over time. The opposite is true for serviceable hearing. There was also a decrease in the percentage of the justification “young age” in the MS category.
Conclusion
The is a continuing trend towards non-surgical treatment. Small- to medium-sized VS witnessed an increase in both WS and SRT. There is only an increase in SRT for moderately large VS. Physicians are less and less considering young age as a factor favoring MS over SRT. There is a tendency towards favoring SRT when hearing is serviceable.</description><identifier>ISSN: 0937-4477</identifier><identifier>EISSN: 1434-4726</identifier><identifier>DOI: 10.1007/s00405-023-08009-6</identifier><identifier>PMID: 37195345</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Dose Fractionation, Radiation ; Female ; Follow-Up Studies ; Head and Neck Surgery ; Hearing ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neuroma, Acoustic - pathology ; Neuroma, Acoustic - surgery ; Neurosurgery ; Otology ; Otorhinolaryngology ; Retrospective Studies ; Treatment Outcome</subject><ispartof>European archives of oto-rhino-laryngology, 2023-11, Vol.280 (11), p.4885-4894</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-c995a996667b7457345d06d801a9ba0f92a7d62f81d3b0d692d6d76ffa627c893</citedby><cites>FETCH-LOGICAL-c347t-c995a996667b7457345d06d801a9ba0f92a7d62f81d3b0d692d6d76ffa627c893</cites><orcidid>0000-0002-8482-8109</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00405-023-08009-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00405-023-08009-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37195345$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>El Sayed Ahmad, Youssef</creatorcontrib><creatorcontrib>Gallois, Yohan</creatorcontrib><creatorcontrib>Sol, Jean Christophe</creatorcontrib><creatorcontrib>Boetto, Sergio</creatorcontrib><creatorcontrib>Attal, Justine</creatorcontrib><creatorcontrib>Sabatier, Jean</creatorcontrib><creatorcontrib>Debs, Rachel</creatorcontrib><creatorcontrib>Deguine, Olivier</creatorcontrib><creatorcontrib>Marx, Mathieu</creatorcontrib><title>Evolution in the management of vestibular schwannoma: a single-center 15-year experience</title><title>European archives of oto-rhino-laryngology</title><addtitle>Eur Arch Otorhinolaryngol</addtitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><description>Purpose
To highlight the changes in the management of vestibular schwannoma (VS) since 2004 with a focus on small- to middle-size VS.
Methods
Retrospective analysis of the decisions made in skull base tumor board between 2004 and 2021.
Results
1819 decisions were analyzed (average age 59.25, 54% females). Overall, 850 (47%) cases were allocated to a Wait and Scan (WS) approach, 416 (23%) received radiotherapy and 553 (30%) were treated surgically (MS). All stages considered WS increased from 39% before 2010 to 50% after 2010. Similarly, Stereotactic Radio Therapy (SRT) increased from 5 to 18%. MS decreased from 46 to 25%. It was more commonly proposed to younger patients and larger tumors,
p
< 0.001. For Koos stages 1, 2, and 3 there was a statistically significant increase in SRT, and a decrease in MS,
p
< 0.001. WS also increased for stages 1 and 2. However, such a trend was not observed for stage 3. MS remained the primary treatment modality for stage 4 tumors throughout the study period,
p
= 0.057. The significance of advanced age as a factor favoring SRT decreased over time. The opposite is true for serviceable hearing. There was also a decrease in the percentage of the justification “young age” in the MS category.
Conclusion
The is a continuing trend towards non-surgical treatment. Small- to medium-sized VS witnessed an increase in both WS and SRT. There is only an increase in SRT for moderately large VS. Physicians are less and less considering young age as a factor favoring MS over SRT. There is a tendency towards favoring SRT when hearing is serviceable.</description><subject>Dose Fractionation, Radiation</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Head and Neck Surgery</subject><subject>Hearing</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neuroma, Acoustic - pathology</subject><subject>Neuroma, Acoustic - surgery</subject><subject>Neurosurgery</subject><subject>Otology</subject><subject>Otorhinolaryngology</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0937-4477</issn><issn>1434-4726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1P3DAQhi1UxC4Lf4BD5WMvhnH8FXOrEP2QkHopEjfLSSa7WSXO1k4o--9r2KVHTnOY53018xByxeGaA5ibBCBBMSgEgxLAMn1CllwKyaQp9CeyBCsMk9KYBTlPaQsASlpxRhbCcKuEVEvydP889vPUjYF2gU4bpIMPfo0DhomOLX3GNHXV3PtIU73560MYB39LPU1dWPfI6sxhpFyxPWYGX3YYOww1XpDT1vcJL49zRR6_3f---8Eefn3_eff1gdVCmonV1ipvrdbaVEYqk49qQDclcG8rD60tvGl00Za8ERU02haNboxuW68LU5dWrMiXQ-8ujn_mfK0bulRj3_uA45xcUXJZclVKldHigNZxTCli63axG3zcOw7u1ag7GHXZqHsz6nQOfT72z9WAzf_Iu8IMiAOQ8iqsMbrtOMeQf_6o9h82UYDS</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>El Sayed Ahmad, Youssef</creator><creator>Gallois, Yohan</creator><creator>Sol, Jean Christophe</creator><creator>Boetto, Sergio</creator><creator>Attal, Justine</creator><creator>Sabatier, Jean</creator><creator>Debs, Rachel</creator><creator>Deguine, Olivier</creator><creator>Marx, Mathieu</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8482-8109</orcidid></search><sort><creationdate>20231101</creationdate><title>Evolution in the management of vestibular schwannoma: a single-center 15-year experience</title><author>El Sayed Ahmad, Youssef ; Gallois, Yohan ; Sol, Jean Christophe ; Boetto, Sergio ; Attal, Justine ; Sabatier, Jean ; Debs, Rachel ; Deguine, Olivier ; Marx, Mathieu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-c995a996667b7457345d06d801a9ba0f92a7d62f81d3b0d692d6d76ffa627c893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Dose Fractionation, Radiation</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Head and Neck Surgery</topic><topic>Hearing</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neuroma, Acoustic - pathology</topic><topic>Neuroma, Acoustic - surgery</topic><topic>Neurosurgery</topic><topic>Otology</topic><topic>Otorhinolaryngology</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>El Sayed Ahmad, Youssef</creatorcontrib><creatorcontrib>Gallois, Yohan</creatorcontrib><creatorcontrib>Sol, Jean Christophe</creatorcontrib><creatorcontrib>Boetto, Sergio</creatorcontrib><creatorcontrib>Attal, Justine</creatorcontrib><creatorcontrib>Sabatier, Jean</creatorcontrib><creatorcontrib>Debs, Rachel</creatorcontrib><creatorcontrib>Deguine, Olivier</creatorcontrib><creatorcontrib>Marx, Mathieu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European archives of oto-rhino-laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>El Sayed Ahmad, Youssef</au><au>Gallois, Yohan</au><au>Sol, Jean Christophe</au><au>Boetto, Sergio</au><au>Attal, Justine</au><au>Sabatier, Jean</au><au>Debs, Rachel</au><au>Deguine, Olivier</au><au>Marx, Mathieu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evolution in the management of vestibular schwannoma: a single-center 15-year experience</atitle><jtitle>European archives of oto-rhino-laryngology</jtitle><stitle>Eur Arch Otorhinolaryngol</stitle><addtitle>Eur Arch Otorhinolaryngol</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>280</volume><issue>11</issue><spage>4885</spage><epage>4894</epage><pages>4885-4894</pages><issn>0937-4477</issn><eissn>1434-4726</eissn><abstract>Purpose
To highlight the changes in the management of vestibular schwannoma (VS) since 2004 with a focus on small- to middle-size VS.
Methods
Retrospective analysis of the decisions made in skull base tumor board between 2004 and 2021.
Results
1819 decisions were analyzed (average age 59.25, 54% females). Overall, 850 (47%) cases were allocated to a Wait and Scan (WS) approach, 416 (23%) received radiotherapy and 553 (30%) were treated surgically (MS). All stages considered WS increased from 39% before 2010 to 50% after 2010. Similarly, Stereotactic Radio Therapy (SRT) increased from 5 to 18%. MS decreased from 46 to 25%. It was more commonly proposed to younger patients and larger tumors,
p
< 0.001. For Koos stages 1, 2, and 3 there was a statistically significant increase in SRT, and a decrease in MS,
p
< 0.001. WS also increased for stages 1 and 2. However, such a trend was not observed for stage 3. MS remained the primary treatment modality for stage 4 tumors throughout the study period,
p
= 0.057. The significance of advanced age as a factor favoring SRT decreased over time. The opposite is true for serviceable hearing. There was also a decrease in the percentage of the justification “young age” in the MS category.
Conclusion
The is a continuing trend towards non-surgical treatment. Small- to medium-sized VS witnessed an increase in both WS and SRT. There is only an increase in SRT for moderately large VS. Physicians are less and less considering young age as a factor favoring MS over SRT. There is a tendency towards favoring SRT when hearing is serviceable.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37195345</pmid><doi>10.1007/s00405-023-08009-6</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-8482-8109</orcidid></addata></record> |
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| ispartof | European archives of oto-rhino-laryngology, 2023-11, Vol.280 (11), p.4885-4894 |
| issn | 0937-4477 1434-4726 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2814815845 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Dose Fractionation, Radiation Female Follow-Up Studies Head and Neck Surgery Hearing Humans Male Medicine Medicine & Public Health Middle Aged Neuroma, Acoustic - pathology Neuroma, Acoustic - surgery Neurosurgery Otology Otorhinolaryngology Retrospective Studies Treatment Outcome |
| title | Evolution in the management of vestibular schwannoma: a single-center 15-year experience |
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