Short-Term Surgical Outcome for Vestibular Schwannoma in Sweden: A Nation-Wide Registry Study
Background: Vestibular Schwannoma (VS) is a benign neoplasm arising from the 8th cranial nerve, with surgery one of the treatment modalities. In a nation-wide registry study, we describe the baseline, treatment characteristics, and short-term outcome in patients surgically treated for VS.Methods: We...
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| Format: | Article |
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Frontiers Media S.A.
2019-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00043/full |
| _version_ | 1819267510326788096 |
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| author | Jiri Bartek Jr. Jiri Bartek Jr. Jiri Bartek Jr. Petter Förander Erik Thurin Theresa Wangerid Roger Henriksson Roger Henriksson Göran Hesselager Asgeir Store Jakola Asgeir Store Jakola Asgeir Store Jakola |
| author_facet | Jiri Bartek Jr. Jiri Bartek Jr. Jiri Bartek Jr. Petter Förander Erik Thurin Theresa Wangerid Roger Henriksson Roger Henriksson Göran Hesselager Asgeir Store Jakola Asgeir Store Jakola Asgeir Store Jakola |
| author_sort | Jiri Bartek Jr. |
| collection | DOAJ |
| description | Background: Vestibular Schwannoma (VS) is a benign neoplasm arising from the 8th cranial nerve, with surgery one of the treatment modalities. In a nation-wide registry study, we describe the baseline, treatment characteristics, and short-term outcome in patients surgically treated for VS.Methods: We performed a nationwide study with data from the Swedish Brain Tumor Registry (SBTR) for all adults diagnosed with VS 2009–2015. Patient symptoms, tumor characteristics, and postoperative complications were analyzed.Results: In total 348 patients underwent surgery for VS. Mean age was 50.6 ± 14.5 years and 165 patients (47.4%) were female. The most common symptom was focal neurological deficit (92.0%), with only 25 (7.2%) being asymptomatic prior to surgery, and 217 (63.6%) had no restriction in activity. Following surgery, 100 (28.7%) patients developed new deficit(s). In terms of postoperative complications; 11 (3.2%) had a hematoma, 35 (10.1%) an infection, 10 (2.9%) a venous thromboembolism, and 23 (6.6%) had a reoperation due to complication. There were no deaths within 30-days after surgery. When grouped according to tumor size (< 4 vs. ≥4 cm), those with ≥4 cm tumors were more often males (p = 0.02), had more often ICP related symptoms (p = 0.03) and shorter time from imaging to surgery (p < 0.01). Analysis of the younger (< 65 years) vs. elderly (≥65 years) revealed no difference in outcome except increased 1-year mortality (p = 0.002) in elderly.Conclusion: In this nation-wide registry-study, we benchmark the 30-day complication rate after VS surgery as collected by the SBTR. Further, we present the current neurosurgical outcome data from both VS smaller than 40 mm compared to larger tumors, as well as younger vs. elderly VS patients. Since surgical decision making is a careful consideration of short term risk vs. long term benefit, this information can be useful in clinical decision making. |
| first_indexed | 2024-12-23T21:18:19Z |
| format | Article |
| id | doaj.art-f87f59de1c594c96a8ea8bacd8c768eb |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-23T21:18:19Z |
| publishDate | 2019-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-f87f59de1c594c96a8ea8bacd8c768eb2022-12-21T17:30:51ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-01-011010.3389/fneur.2019.00043432856Short-Term Surgical Outcome for Vestibular Schwannoma in Sweden: A Nation-Wide Registry StudyJiri Bartek Jr.0Jiri Bartek Jr.1Jiri Bartek Jr.2Petter Förander3Erik Thurin4Theresa Wangerid5Roger Henriksson6Roger Henriksson7Göran Hesselager8Asgeir Store Jakola9Asgeir Store Jakola10Asgeir Store Jakola11Department of Neurosurgery, Karolinska University Hospital, Stockholm, SwedenDepartment of Clinical Neuroscience and Department of Medicine, Karolinska Institutet, Stockholm, SwedenDepartment of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, DenmarkDepartment of Neurosurgery, Karolinska University Hospital, Stockholm, SwedenDepartment of Neurology, Sahlgrenska University Hospital, Gothenburg, SwedenDepartment of Neurology, Capio St. Göran Hospital, Stockholm, SwedenRegional Cancer Centre Stockholm/Gotland, Stockholm, SwedenDepartment of Radiation Sciences and Oncology, University of Umeå, Umeå, SwedenDepartment of Neurosurgery, Uppsala University Hospital, Uppsala, SwedenDepartment of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden0Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden1Department of Neurosurgery, St. Olavs University Hospital, Trondheim, NorwayBackground: Vestibular Schwannoma (VS) is a benign neoplasm arising from the 8th cranial nerve, with surgery one of the treatment modalities. In a nation-wide registry study, we describe the baseline, treatment characteristics, and short-term outcome in patients surgically treated for VS.Methods: We performed a nationwide study with data from the Swedish Brain Tumor Registry (SBTR) for all adults diagnosed with VS 2009–2015. Patient symptoms, tumor characteristics, and postoperative complications were analyzed.Results: In total 348 patients underwent surgery for VS. Mean age was 50.6 ± 14.5 years and 165 patients (47.4%) were female. The most common symptom was focal neurological deficit (92.0%), with only 25 (7.2%) being asymptomatic prior to surgery, and 217 (63.6%) had no restriction in activity. Following surgery, 100 (28.7%) patients developed new deficit(s). In terms of postoperative complications; 11 (3.2%) had a hematoma, 35 (10.1%) an infection, 10 (2.9%) a venous thromboembolism, and 23 (6.6%) had a reoperation due to complication. There were no deaths within 30-days after surgery. When grouped according to tumor size (< 4 vs. ≥4 cm), those with ≥4 cm tumors were more often males (p = 0.02), had more often ICP related symptoms (p = 0.03) and shorter time from imaging to surgery (p < 0.01). Analysis of the younger (< 65 years) vs. elderly (≥65 years) revealed no difference in outcome except increased 1-year mortality (p = 0.002) in elderly.Conclusion: In this nation-wide registry-study, we benchmark the 30-day complication rate after VS surgery as collected by the SBTR. Further, we present the current neurosurgical outcome data from both VS smaller than 40 mm compared to larger tumors, as well as younger vs. elderly VS patients. Since surgical decision making is a careful consideration of short term risk vs. long term benefit, this information can be useful in clinical decision making.https://www.frontiersin.org/article/10.3389/fneur.2019.00043/fullvestibular schwannomaneurosurgeryoutcomecomplicationsstereotactic radiosurgeryhematoma |
| spellingShingle | Jiri Bartek Jr. Jiri Bartek Jr. Jiri Bartek Jr. Petter Förander Erik Thurin Theresa Wangerid Roger Henriksson Roger Henriksson Göran Hesselager Asgeir Store Jakola Asgeir Store Jakola Asgeir Store Jakola Short-Term Surgical Outcome for Vestibular Schwannoma in Sweden: A Nation-Wide Registry Study Frontiers in Neurology vestibular schwannoma neurosurgery outcome complications stereotactic radiosurgery hematoma |
| title | Short-Term Surgical Outcome for Vestibular Schwannoma in Sweden: A Nation-Wide Registry Study |
| title_full | Short-Term Surgical Outcome for Vestibular Schwannoma in Sweden: A Nation-Wide Registry Study |
| title_fullStr | Short-Term Surgical Outcome for Vestibular Schwannoma in Sweden: A Nation-Wide Registry Study |
| title_full_unstemmed | Short-Term Surgical Outcome for Vestibular Schwannoma in Sweden: A Nation-Wide Registry Study |
| title_short | Short-Term Surgical Outcome for Vestibular Schwannoma in Sweden: A Nation-Wide Registry Study |
| title_sort | short term surgical outcome for vestibular schwannoma in sweden a nation wide registry study |
| topic | vestibular schwannoma neurosurgery outcome complications stereotactic radiosurgery hematoma |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.00043/full |
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