TY - JOUR
T1 - Decision Making on Vestibular Schwannoma
T2 - Lessons from a Multidisciplinary Board
AU - Sergi, Bruno
AU - Balducci, Mario
AU - Paludetti, Gaetano
AU - Olivi, Alessandro
AU - Picciotti, Pasqualina Maria
AU - De Corso, Eugenio
AU - Passali, Giulio Cesare
AU - Fetoni, Anna Rita
AU - Lucidi, Daniela
N1 - Funding Information:
Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021
Y1 - 2021
N2 - Background: Management of vestibular schwannoma (VS) is a complex process aimed at identifying a clinical indication for fractionated stereotactic radiotherapy (sRT) or radiosurgery, microsurgical resection, or wait and scan (WS). We describe the experience of our VS multidisciplinary team (MDT) at a tertiary university referral center created for diagnosis, treatment, and follow-up of VS patients. Methods: We conducted a retrospective study on 132 consecutive patients referred to the MDT and managed by observation (WS), microsurgery, or fractionated sRT. The analysis included patient age, tumor size, hearing level, facial nerve function, tumor control, complications, and quality of life questionnaires. Results: Among the patients, 21% were subjected to microsurgery, 10% to sRT, and 69% to WS. The median follow-up time was 30 months. Outcomes based on different management modalities are described. Statistically significant differences among groups were detected in terms of quality of life (physical domain). Conclusions: MDT may provide the best individualized therapy for VS patients compared with a single gold-standard strategy.
AB - Background: Management of vestibular schwannoma (VS) is a complex process aimed at identifying a clinical indication for fractionated stereotactic radiotherapy (sRT) or radiosurgery, microsurgical resection, or wait and scan (WS). We describe the experience of our VS multidisciplinary team (MDT) at a tertiary university referral center created for diagnosis, treatment, and follow-up of VS patients. Methods: We conducted a retrospective study on 132 consecutive patients referred to the MDT and managed by observation (WS), microsurgery, or fractionated sRT. The analysis included patient age, tumor size, hearing level, facial nerve function, tumor control, complications, and quality of life questionnaires. Results: Among the patients, 21% were subjected to microsurgery, 10% to sRT, and 69% to WS. The median follow-up time was 30 months. Outcomes based on different management modalities are described. Statistically significant differences among groups were detected in terms of quality of life (physical domain). Conclusions: MDT may provide the best individualized therapy for VS patients compared with a single gold-standard strategy.
KW - Management
KW - Multidisciplinary
KW - Vestibular schwannoma
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U2 - 10.1016/j.wneu.2021.10.140
DO - 10.1016/j.wneu.2021.10.140
M3 - Article
AN - SCOPUS:85118747307
SN - 1878-8750
JO - World Neurosurgery
JF - World Neurosurgery
ER -