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J Neurol Surg B Skull Base 2012; 73(02): 117-120
DOI: 10.1055/s-0032-1301395
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Volumetric Measurement of Vestibular Schwannoma Tumour Growth Following Partial Resection: Predictors for Recurrence

Siavosh Vakilian
1   Department of Radiation Oncology, McGill University Health Centre, Montreal, Canada
,
Luis Souhami
1   Department of Radiation Oncology, McGill University Health Centre, Montreal, Canada
,
Denis Melançon
2   Department of Radiology, McGill University Health Centre, Montreal, Canada
,
Anthony Zeitouni
3   Department of Otolaryngology–Head and Neck Surgery, McGill University Health Centre, Montreal, Canada
› Author Affiliations
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Publication History

14 June 2011

11 October 2011

Publication Date:
06 February 2012 (online)

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Abstract

Vestibular schwannomas (VS) have a higher risk of recurrence following subtotal resection than following near-total resection. We measured tumor remnant growth volumetrically in an attempt to determine potential predictors for postoperative recurrence following subtotal resection. We reviewed the charts of patients who had undergone VS surgery between 1998 and 2007. Thirty patients had an incomplete resection. The principal outcome measure was change in tumor volume (TV) on serial imaging. At a median follow-up of 6.8 years, volumetric measurements showed that 12 patients (40%) developed further tumor growth, while 18 patients remained with stable residual disease. The median rate of growth was 0.53 cm3/year. Two-dimensional measurements confirmed growth in only eight of these patients. The postoperative residual TV correlated significantly with subsequent tumor growth (p = 0.038). All patients with residual volumes in excess of 2.5 cm3 exhibited recurrence. On univariate analysis, only postoperative TV was significantly associated with growth. Median time to failure was 21.5 months. This is the first report of volumetric measurements of VS tumor growth postoperatively. Volumetric measurements appear to be superior to two-dimensional measurements in documenting VS growth and patients with residual tumors >2.5 cm3 have a significantly higher rate of recurrence.

Keywords

vestibular schwannoma - acoustic neuroma - postoperative growth - volumetric measurement - partial resection
 

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