BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.