Predictors of long-term tumor control after stereotactic radiosurgery for Koos grade 4 vestibular schwannomas

Hasegawa, Toshinori; Kato, Tatsuya; Naitô, Takeshi; Tanei, Takafumi; Ishii, Kazushige; Tsukamoto, Eisuke; Okada, Kou; Ito, Risa; Kouketsu, Yuuta

doi:10.1007/s11060-020-03622-5

Cited by 20 publications

(23 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Even for large tumors, accurate targeting can lead to excellent tumor control with lower prescription doses. In fact, our tumor control rate of 95.6% was similar to those in previous studies, and other factors that were previously associated with control failure, such as younger age and previous resection, were not associated with tumor control in our cohort [8,15].…”

Section: Other Neurological Symptomssupporting

confidence: 90%

“…or in ours. Indeed, our hearing preservation rate (61% at 10 years) was comparable to those in other previous studies (34-66% at 2-7 years after SRS)[8,11,13,15, 16]. Hence, further investigation of the association between tumor size and hearing preservation is necessary.…”

supporting

confidence: 86%

“…this study, SRS yielded long-term tumor control and low complication rates in patients with Koos grade IV VSs.TCRs were satisfactory, at 95.6%, and the hearing, facial nerve, and trigeminal nerve preservation rates were 61.1%, 95.5%, and 91.6%, respectively. SRS was recently reported as an e cacious treatment for large VSs (Table3) [8,11,13,15, 16]. Outcomes of patients with Koos grade I-III VSs in this study are comparable to those of previous studies in terms of tumor control and preservation of neurological function, and also comparable to patients with Koos grade I-III VSs in our cohort.…”

supporting

confidence: 84%

See 2 more Smart Citations

Stereotactic radiosurgery ensures an effective and safe long-term control of Koos grade IV vestibular schwannomas: a single-center, retrospective, cohort study

et al. 2022

View full text Add to dashboard Cite

Purpose: Stereotactic radiosurgery (SRS) is a standard treatment modality for vestibular schwannomas (VSs).However, there is a paucity of data on tumor control and neurological preservation for larger VSs. We aimed to investigate the long-term effectiveness of SRS for Koos grade IV compared with I-III VSs.Methods: We included 452 patients with VSs (50 Koos grade IV and 402 Koos grade I-III) who were treated with SRS at our institution from 1990 to 2021. Tumor control and functional preservation were calculated using the Kaplan-Meier method and compared between groups with the log-rank test.Results: The median post-SRS follow-up period was 68 months. Tumor control rates were 96% at 5 and 10 years for Koos grade IV VSs, and 97% and 95%, respectively, for Koos grade I-III VSs (p = 0.744). In Koos grade IV VSs, functional preservation rates of the facial and trigeminal nerves were both 96% at 5 years (both 98% for Koos grade I-III VSs; facial, p = 0.410; trigeminal, p = 0.107). Hearing preservation rates were 61% at 5 years for Koos grade IV VSs and 78% for Koos grade I-III VSs (p = 0.645). Symptomatic transient tumor expansion was more common with Koos grade IV VSs (8.0% vs. 2.5%, p = 0.034), although all related symptoms diminished in accordance with tumor shrinkage.Conclusion: SRS may contribute to long-term tumor control and adequate neurological preservation in the treatment of Koos grade IV VSs, comparable to those in the treatment of Koos grade I-III VSs.

show abstract

Section: Other Neurological Symptomssupporting

confidence: 90%

supporting

confidence: 86%

supporting

confidence: 84%

See 1 more Smart Citation

Stereotactic radiosurgery ensures an effective and safe long-term control of Koos grade IV vestibular schwannomas: a single-center, retrospective, cohort study

et al. 2022

View full text Add to dashboard Cite

show abstract

“… 9 Of these, only 8 cases (0.7%) were VS. 9 In 1,000 surgical cases of VS, 3.3% had TN, 5 and another paper indicated that even in Koos grade IV 10 and large schwannomas, which present deformity of the brainstem and shift of the fourth ventricle, only 1.2% of cases showed TN. 3 The onset of TN is due to compression by a large VS. 3–6 In particular, the trigeminal nerve is compressed when the tumor grows in an upward direction. 5 It is extremely rare for a VS as small as 12 mm in diameter, as in our case, to present with TN.…”

Section: Discussionmentioning

confidence: 99%

“… 5 The pathogenesis of TN in VS has been shown to involve direct compression of the nerve not only by the VS but also by the blood vessels. 3 , 5 , 6 Additionally, 75% of cases of large VS presenting with TN had vascular compression involvement. 6 When approaching surgery for VS presenting with TN, care should be taken not only to remove the tumor but also to identify the area surrounding the trigeminal nerve and to move the responsible vessels to ensure decompression of the trigeminal nerve.…”

Section: Discussionmentioning

confidence: 99%

Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case

Onoda

Ogasawara²,

Hirokawa

et al. 2022

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

BACKGROUND A vestibular schwannoma (VS) presenting with paroxysmal facial electric shock pain, that is, trigeminal neuralgia (TN), is relatively rare. Furthermore, TN is extremely rare in small VSs. OBSERVATIONS Herein, the authors report the case of a 52-year-old woman with a complaint of right TN. Magnetic resonance (MR) imaging revealed a right VS of 12-mm diameter that compressed the trigeminal nerve. Although she did not report any hearing impairment, audiometry revealed decreased high-frequency range on the right side. The tumor was excised using the right retrosigmoid approach, and TN was confirmed to be caused by direct compression of the trigeminal nerve by the VS. Sufficient decompression of trigeminal nerve was done. The proximity of the trigeminal nerve root to the vestibular nerve root was the cause of TN. TN disappeared immediately after surgery, and there was no worsening of hearing impairment and facial paralysis. LESSONS It is important to remember that TN may occur with direct tumor compression, even in small VSs. A preoperative 3-dimensional MR cisternogram/angiogram fusion image clearly showed direct tumor compression of the trigeminal nerve and the absence of responsible vessels, which was useful for surgical planning.

show abstract

Stereotactic radiosurgery for Koos grade IV vestibular schwannoma in patients ≥ 65 years old: a multi-institutional retrospective study

et al. 2022

View full text Add to dashboard Cite

Predictors of long-term tumor control after stereotactic radiosurgery for Koos grade 4 vestibular schwannomas

Cited by 20 publications

References 34 publications

Stereotactic radiosurgery ensures an effective and safe long-term control of Koos grade IV vestibular schwannomas: a single-center, retrospective, cohort study

Stereotactic radiosurgery ensures an effective and safe long-term control of Koos grade IV vestibular schwannomas: a single-center, retrospective, cohort study

Small vestibular schwannoma presented with trigeminal neuralgia: illustrative case

Stereotactic radiosurgery for Koos grade IV vestibular schwannoma in patients ≥ 65 years old: a multi-institutional retrospective study

Contact Info

Product

Resources

About