Extent of resection and the long-term durability of vestibular schwannoma surgery: Clinical article

Michael E. Sughrue, Rajwant Kaur, Martin J. Rutkowski, Ari J. Kane, Gurvinder Kaur, Isaac Yang, Lawrence H. Pitts, Andrew T. Parsa

Research output: Contribution to journalArticle

Abstract

Object. With limited studies available, the correlation between the extent of resection and tumor recurrence in vestibular schwannomas (VSs) has not been definitively established. In this prospective study, the authors evaluated 772 patients who underwent microsurgical resection of VSs to analyze the association between total tumor resection and the tumor recurrence rate. Methods. The authors selected all cases from a prospectively collected database of patients who underwent microsurgical resection as their initial treatment for a histopathologically confirmed VS. Recurrence-free survival was analyzed using Kaplan-Meier analysis. The authors studied the impact of possible confounders such as patient age and tumor size using stepwise Cox regression to calculate the proportional hazard ratio of recurrence while controlling for other cofounding variables. Results. The authors analyzed data obtained in 571, 89, and 112 patients in whom gross-total, near-total, and subtotal resections, respectively, were performed. A gross-total resection was achieved in 74% of the patients, and the overall recurrence rate in these patients 8.8%. There was no significant relation between the extent of resection and the rate of tumor recurrence (p = 0.58). As expected, the extent of resection was highly correlated with patient age, tumor size, and surgical approach (p < 0.0001). Using Cox regression, the authors found that the approach used did not significantly affect tumor control when the extent of resection was controlled for. Conclusions. While complete tumor removal is ideal, the results presented here suggest that there is no signifi- cant relationship between the extent of resection and tumor recurrence.

Original languageEnglish (US)
Pages (from-to)1218-1223
Number of pages6
JournalJournal of neurosurgery
Volume114
Issue number5
DOIs
StatePublished - May 1 2011
Externally publishedYes

Fingerprint

Acoustic Neuroma
Recurrence
Neoplasms
Kaplan-Meier Estimate
Databases
Prospective Studies
Survival

Keywords

  • Acoustic neuroma
  • Gross tumor resection
  • Microsurgery
  • Recurrence
  • Vestibular schwannoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Sughrue, M. E., Kaur, R., Rutkowski, M. J., Kane, A. J., Kaur, G., Yang, I., ... Parsa, A. T. (2011). Extent of resection and the long-term durability of vestibular schwannoma surgery: Clinical article. Journal of neurosurgery, 114(5), 1218-1223. https://doi.org/10.3171/2010.11.JNS10257

Extent of resection and the long-term durability of vestibular schwannoma surgery : Clinical article. / Sughrue, Michael E.; Kaur, Rajwant; Rutkowski, Martin J.; Kane, Ari J.; Kaur, Gurvinder; Yang, Isaac; Pitts, Lawrence H.; Parsa, Andrew T.

In: Journal of neurosurgery, Vol. 114, No. 5, 01.05.2011, p. 1218-1223.

Research output: Contribution to journalArticle

Sughrue, ME, Kaur, R, Rutkowski, MJ, Kane, AJ, Kaur, G, Yang, I, Pitts, LH & Parsa, AT 2011, 'Extent of resection and the long-term durability of vestibular schwannoma surgery: Clinical article', Journal of neurosurgery, vol. 114, no. 5, pp. 1218-1223. https://doi.org/10.3171/2010.11.JNS10257
Sughrue, Michael E. ; Kaur, Rajwant ; Rutkowski, Martin J. ; Kane, Ari J. ; Kaur, Gurvinder ; Yang, Isaac ; Pitts, Lawrence H. ; Parsa, Andrew T. / Extent of resection and the long-term durability of vestibular schwannoma surgery : Clinical article. In: Journal of neurosurgery. 2011 ; Vol. 114, No. 5. pp. 1218-1223.
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abstract = "Object. With limited studies available, the correlation between the extent of resection and tumor recurrence in vestibular schwannomas (VSs) has not been definitively established. In this prospective study, the authors evaluated 772 patients who underwent microsurgical resection of VSs to analyze the association between total tumor resection and the tumor recurrence rate. Methods. The authors selected all cases from a prospectively collected database of patients who underwent microsurgical resection as their initial treatment for a histopathologically confirmed VS. Recurrence-free survival was analyzed using Kaplan-Meier analysis. The authors studied the impact of possible confounders such as patient age and tumor size using stepwise Cox regression to calculate the proportional hazard ratio of recurrence while controlling for other cofounding variables. Results. The authors analyzed data obtained in 571, 89, and 112 patients in whom gross-total, near-total, and subtotal resections, respectively, were performed. A gross-total resection was achieved in 74{\%} of the patients, and the overall recurrence rate in these patients 8.8{\%}. There was no significant relation between the extent of resection and the rate of tumor recurrence (p = 0.58). As expected, the extent of resection was highly correlated with patient age, tumor size, and surgical approach (p < 0.0001). Using Cox regression, the authors found that the approach used did not significantly affect tumor control when the extent of resection was controlled for. Conclusions. While complete tumor removal is ideal, the results presented here suggest that there is no signifi- cant relationship between the extent of resection and tumor recurrence.",
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N2 - Object. With limited studies available, the correlation between the extent of resection and tumor recurrence in vestibular schwannomas (VSs) has not been definitively established. In this prospective study, the authors evaluated 772 patients who underwent microsurgical resection of VSs to analyze the association between total tumor resection and the tumor recurrence rate. Methods. The authors selected all cases from a prospectively collected database of patients who underwent microsurgical resection as their initial treatment for a histopathologically confirmed VS. Recurrence-free survival was analyzed using Kaplan-Meier analysis. The authors studied the impact of possible confounders such as patient age and tumor size using stepwise Cox regression to calculate the proportional hazard ratio of recurrence while controlling for other cofounding variables. Results. The authors analyzed data obtained in 571, 89, and 112 patients in whom gross-total, near-total, and subtotal resections, respectively, were performed. A gross-total resection was achieved in 74% of the patients, and the overall recurrence rate in these patients 8.8%. There was no significant relation between the extent of resection and the rate of tumor recurrence (p = 0.58). As expected, the extent of resection was highly correlated with patient age, tumor size, and surgical approach (p < 0.0001). Using Cox regression, the authors found that the approach used did not significantly affect tumor control when the extent of resection was controlled for. Conclusions. While complete tumor removal is ideal, the results presented here suggest that there is no signifi- cant relationship between the extent of resection and tumor recurrence.

AB - Object. With limited studies available, the correlation between the extent of resection and tumor recurrence in vestibular schwannomas (VSs) has not been definitively established. In this prospective study, the authors evaluated 772 patients who underwent microsurgical resection of VSs to analyze the association between total tumor resection and the tumor recurrence rate. Methods. The authors selected all cases from a prospectively collected database of patients who underwent microsurgical resection as their initial treatment for a histopathologically confirmed VS. Recurrence-free survival was analyzed using Kaplan-Meier analysis. The authors studied the impact of possible confounders such as patient age and tumor size using stepwise Cox regression to calculate the proportional hazard ratio of recurrence while controlling for other cofounding variables. Results. The authors analyzed data obtained in 571, 89, and 112 patients in whom gross-total, near-total, and subtotal resections, respectively, were performed. A gross-total resection was achieved in 74% of the patients, and the overall recurrence rate in these patients 8.8%. There was no significant relation between the extent of resection and the rate of tumor recurrence (p = 0.58). As expected, the extent of resection was highly correlated with patient age, tumor size, and surgical approach (p < 0.0001). Using Cox regression, the authors found that the approach used did not significantly affect tumor control when the extent of resection was controlled for. Conclusions. While complete tumor removal is ideal, the results presented here suggest that there is no signifi- cant relationship between the extent of resection and tumor recurrence.

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