Wiet R J, Zappia J J, Hecht C S, O'Connor C A
Department of Otolaryngology-Head and Neck Surgery, Northwestern University Medical School, Chicago, USA.
Laryngoscope. 1995 Aug;105(8 Pt 1):795-800. doi: 10.1288/00005537-199508000-00005.
Of 432 patients referred for treatment of their cerebellopontine angle tumors, 53 with acoustic neuromas were managed initially without intervention but with adequate follow-up. Mean presenting tumor size in this subgroup of patients was 0.98 cm (range, 0.2 to 3.0 cm), and average growth rate was 0.16 cm per year. Twenty-one patients demonstrated tumor growth with a mean follow-up interval of 1.9 years. Of these 21 patients, 14 underwent microsurgical excision, 4 received radiation, 2 continued to be observed and 1 was lost to follow-up. The remaining 32 (60%) had no demonstrable growth with a mean follow-up of 2.13 years. Of these patients, 29 continue to be followed and 3 were lost to follow-up. Of the information evaluated, the only statistically significant relationship is with larger tumor size in elderly patients--most likely reflecting the propensity to opt for conservative treatment in elderly patients. Tumor growth rate was unrelated to presenting tumor size or patient age, which suggests that conservative treatment may be appropriate in selected patients.
在432例因桥小脑角肿瘤前来接受治疗的患者中，53例听神经瘤患者最初未接受干预，而是进行了充分的随访。该亚组患者的肿瘤初始大小平均为0.98厘米（范围为0.2至3.0厘米），平均生长速度为每年0.16厘米。21例患者出现肿瘤生长，平均随访间隔为1.9年。在这21例患者中，14例接受了显微手术切除，4例接受了放疗，2例继续观察，1例失访。其余32例（60%）在平均2.13年的随访中未出现明显生长。在这些患者中，29例继续接受随访，3例失访。在所评估的信息中，唯一具有统计学意义的关系是老年患者肿瘤较大——这很可能反映了老年患者倾向于选择保守治疗。肿瘤生长速度与肿瘤初始大小或患者年龄无关，这表明在部分患者中保守治疗可能是合适的。
