Wang Sophie Shih-Yüng, Horstmann Gerhard, Renovanz Mirjam, van Eck Albertus, Tatagiba Marcos, Naros Georgios
Center for Neuro-Oncology, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany.
Department of Neurosurgery, University Hospital Tubingen & Eberhard Karls University, Tubingen, Germany.
Neurooncol Adv. 2025 Jan 29;7(1):vdaf025. doi: 10.1093/noajnl/vdaf025. eCollection 2025 Jan-Dec.
Sex-related differences in patients with sporadic, unilateral vestibular schwannoma (VS) are poorly investigated so far, and it remains unclear whether biological sex affects treatment response to stereotactic radiosurgery () or microsurgical resection (). This study elucidates sex-related differences in treatment outcome of VS.
This is a retrospective two-center cohort study. All consecutive patients treated for their VS between 2005 and 2012 were included. Previously treated VS and patients with neurofibromatosis were excluded. Clinical status and treatment-related complications were analyzed from both centers' prospective treatment registries. Recurrence/progression-free-survival was assessed radiographically by contrast-enhanced magnetic resonance imaging.
Within the entire patient cohort of = 1,118, the majority of VS patients (56%) was female. Sixty-two percent of patients were treated by . Females with very small tumors (KOOS I) were significantly less likely to be assigned to than males (.009). Mean follow-up time was 6 ± 4.3 years. In , the rate of subtotal resection was significantly higher in women (7%) compared to men (2%) (.041). However, there was no difference in long-term tumor control after between both sexes (.729). In however, the incidence of recurrence was significantly higher in women (14%) compared to men (8%) ( = .004), which was also reflected in the Kaplan-Meier analysis ( = .031).
Female sex was a negative prognostic factor for treatment success (long-term tumor control) if treated with -there was no sex-related differences in long-term tumor control after . Additional research is needed to elucidate sex-related differences in tumor biology affecting the response to VS treatment.
迄今为止，散发性单侧前庭神经鞘瘤（VS）患者的性别差异研究较少，生物性别是否会影响立体定向放射外科治疗（SRS）或显微手术切除（MS）的治疗反应仍不清楚。本研究阐明了VS治疗结果中的性别差异。
这是一项回顾性双中心队列研究。纳入了2005年至2012年间所有连续接受VS治疗的患者。排除先前接受过治疗的VS患者和神经纤维瘤病患者。从两个中心的前瞻性治疗登记处分析临床状况和治疗相关并发症。通过对比增强磁共振成像对复发/无进展生存期进行影像学评估。
在总共1118例患者队列中，大多数VS患者（56%）为女性。62%的患者接受了SRS治疗。肿瘤非常小（KOOS I）的女性被分配接受SRS治疗的可能性明显低于男性（P = 0.009）。平均随访时间为6±4.3年。在MS治疗中，女性的次全切除率（7%）显著高于男性（2%）（P = 0.041）。然而，SRS治疗后两性的长期肿瘤控制情况没有差异（P = 0.729）。然而，在MS治疗中，女性的复发率（14%）显著高于男性（8%）（P = 0.004），这在Kaplan-Meier分析中也得到了体现（P = 0.031）。
如果采用MS治疗，女性是治疗成功（长期肿瘤控制）的不良预后因素——SRS治疗后长期肿瘤控制不存在性别差异。需要进一步研究以阐明影响VS治疗反应的肿瘤生物学中的性别差异。
