Cambridge University Teaching Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK.
Otol Neurotol. 2012 Aug;33(6):1053-8. doi: 10.1097/MAO.0b013e3182595454.
To assess the growth characteristics of small- to medium-sized vestibular schwannomas in patients undergoing watch, wait, and rescan management.
Cohort study using prospectively collected size and tumor morphology data.
Tertiary referral center for cranial base surgery.
Three hundred eighty-one patients with sporadic unilateral vestibular schwannomas and 2 or more magnetic resonance scans were included. Linear measurements were used to assess tumor size. The point of growth and pattern of growth progression were assessed. Factors influencing growth were investigated.
Approximately 33% of tumors demonstrated significant growth. Mean size at presentation was 9.9 mm (standard deviation [SD]. 4.8). For growing tumors, mean size at final review was 13.7 mm (SD, 4.8). This was a statistically significant increase in size (p < 0.0001). Mean annual change in size for growing tumors was 2.3 mm (SD, 2.3). 52.4% of growing tumors showed radiologically demonstrable first growth within 18 months of presentation. Approximately 7.2% of tumors showed radiologically demonstrable first growth after 5 years of follow-up. There were no demographic or morphologic predictors of growth.
Tumor growth is usually slow and is most likely to occur within the first 3 years of observation. Growth may occur after five years of follow-up. A protocol for the scanning of patients is suggested based on the findings of the study.
评估行观察、等待和复查策略的患者中小及中等大小前庭神经鞘瘤的生长特征。
采用前瞻性收集大小和肿瘤形态数据的队列研究。
颅底外科的三级转诊中心。
共纳入 381 例单侧散发性前庭神经鞘瘤患者，这些患者有 2 次或以上磁共振扫描。线性测量用于评估肿瘤大小。评估肿瘤生长的起始点和生长进展模式。研究了影响生长的因素。
约 33%的肿瘤显示出明显的生长。就诊时的平均大小为 9.9mm（标准差[SD]，4.8）。在最后一次复查时，生长肿瘤的平均大小为 13.7mm（SD，4.8）。这是一个统计学上显著的大小增加（p<0.0001）。生长肿瘤的平均每年大小变化为 2.3mm（SD，2.3）。52.4%的生长肿瘤在就诊后 18 个月内出现影像学可见的首次生长。约 7.2%的肿瘤在随访 5 年后出现影像学可见的首次生长。没有发现生长的人口统计学或形态学预测因素。
肿瘤生长通常缓慢，最有可能发生在观察的前 3 年内。生长可能发生在随访 5 年后。根据研究结果，建议制定患者扫描方案。
