TY  - JOUR
A1  - Won, Sae-Yeon
A1  - Kilian, Andreas
A1  - Dubinski, Daniel
A1  - Geßler, Florian
A1  - Dinc, Nazife
A1  - Lauer, Monika
A1  - Wolff, Robert Jürgen
A1  - Freiman, Thomas Michael
A1  - Senft, Christian
A1  - Konczalla, Jürgen
A1  - Forster, Marie-Therese
A1  - Seifert, Volker
T1  - Microsurgical treatment and follow-up of KOOS grade IV vestibular schwannoma: therapeutic concept and future perspective
T2  - Frontiers in oncology
N2  - Purpose: Surgery of KOOS IV vestibular schwannoma remains challenging regarding the balance of extent of tumor resection (EoR) and functional outcome. Our aim was to evaluate the outcome of surgical resection and define a cut-off value for safe resection with low risk for tumor regrowth of KOOS IV vestibular schwannoma.
Methods: All patients presenting at the authors’ institution between 2000 and 2019 with surgically treated KOOS IV vestibular schwannoma were included. Outcome measures included EoR, facial/hearing nerve function, surgical complications and progression of residual tumor during the median follow-up period of 28 months.
Results: In 58 patients, mean tumor volume was 17.1 ± 9.2 cm3, and mean EoR of 81.6 ± 16.8% could be achieved. Fifty-one patients were available for the follow-up analysis. Growth of residual tumor was observed in 11 patients (21.6%) followed by adjuvant treatment with stereotactic radiosurgery or repeat surgery in 15 patients (29.4%). Overall serviceable hearing preservation was achieved in 38 patients (74.5%) and good facial outcome at discharge was observed in 66.7% of patients, significantly increasing to 82.4% at follow-up. Independent predictors for residual tumor growth was EoR ≤ 87% (OR11.1) with a higher EoR being associated with a very low number of residual tumor progression amounting to 7.1% at follow-up (p=0.008).
Conclusions: Subtotal tumor resection is a good therapeutic concept in patients with KOOS IV vestibular schwannoma resulting in a high rate of good hearing and facial nerve function and a very low rate of subsequent tumor progression. The goal of surgery should be to achieve more than 87% of tumor resection to keep residual tumor progression low.
KW  - vestibular schwannoma
KW  - facial nerve functional outcome
KW  - hearing nerve
KW  - KOOS IV
KW  - microsurgical treatment
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/57079
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-570790
SN  - 2234-943X
VL  - 10
IS  - art 6053167
PB  - Frontiers Media
CY  - Lausanne
ER  -