Journal article
Vestibular Schwannoma Koos Grade I International Study of Active Surveillance Versus Stereotactic Radiosurgery: The VISAS-K1 Study
Neurosurgery, v 96(1), pp 41-49
01 Jan 2025
PMID: 39503441
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND AND OBJECTIVE: This investigation evaluates the safety and efficacy of stereotactic radiosurgery (SRS) vs observation for Koos grade I vestibular schwannomas (VS). METHODS: In a multicenter study, we retrospectively analyzed data of patients with Koos grade I VS who underwent SRS (SRS group) or were observed (observation group). Propensity score matching was used to equilibrate demographics, tumor size, and audiometric data across groups. The outcome analyzed included tumor control, preservation of serviceable hearing, and neurological function. RESULTS: The study matched 142 patients, providing a median follow-up period of 36 months. SRS significantly enhanced tumor control compared with observation, with a 100% control rate at both 5- and 8-year marks in the SRS group vs 48.6% and 29.5% in the observation group at the same time intervals, respectively (P < .001). Preservation of serviceable hearing outcomes between groups showed no significant difference at 5 and 8 years, ensuring a comparable quality of auditory function (SRS 70.1% vs observation 53.4% at 5 years; P = .33). Furthermore, SRS was associated with a reduced likelihood of tinnitus (odds ratio [OR] = 0.46, P = .04), vestibular dysfunction (OR = 0.17, P = .002), and overall cranial nerve dysfunction (OR = 0.49, P = .03) at last follow-up. CONCLUSION: SRS management of patients with Koos grade I VS was associated with superior tumor control and reduced odds for cranial nerve dysfunction, while not compromising hearing preservation compared with observation. These findings support the safety and efficacy of SRS as a primary care approach for this patient population.
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Details
- Title
- Vestibular Schwannoma Koos Grade I International Study of Active Surveillance Versus Stereotactic Radiosurgery: The VISAS-K1 Study
- Creators
- Othman Bin-Alamer - University of Pittsburgh Medical CenterHussam Abou-Al-Shaar - University of Pittsburgh Medical CenterSelcuk Peker - Koç UniversityYavuz Samanci - Koç UniversityIsabelle Pelcher - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellSabrina Begley - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellAnuj Goenka - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellMichael Schulder - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellJean-Nicolas Tourigny - Université de SherbrookeDavid Mathieu - Université de SherbrookeAndreanne Hamel - Université de SherbrookeRobert G. Briggs - University of Southern CaliforniaCheng Yu - University of Southern CaliforniaGabriel Zada - University of Southern CaliforniaSteven L. Giannotta - University of Southern CaliforniaHerwin Speckter - Instituto Tecnológico de Santo DomingoSarai Palque - Instituto Tecnológico de Santo DomingoManjul Tripathi - Post Graduate Institute of Medical Education and ResearchSaurabh Kumar - Post Graduate Institute of Medical Education and ResearchRupinder Kaur - Post Graduate Institute of Medical Education and ResearchNarendra Kumar - Post Graduate Institute of Medical Education and ResearchBrandon Rogowski - Drexel UniversityMatthew J. Shepard - Allegheny Health NetworkBryan A. Johnson - Mayo Clinic in FloridaDaniel M. Trifiletti - Mayo Clinic in FloridaRonald E. Warnick - Jewish HospitalSamantha Dayawansa - University of VirginiaElad Mashiach - Manhattan Institute for Policy ResearchFernando De Nigris Vasconcellos - NYU Langone, Dept Neurosurg, New York, NY USAKenneth Bernstein - NYU Langone, Dept Radiat Oncol, New York, NY USAZane Schnurman - Manhattan Institute for Policy ResearchJuan Alzate - Manhattan Institute for Policy ResearchDouglas Kondziolka - Manhattan Institute for Policy ResearchJason P. Sheehan - University of Virginia
- Publication Details
- Neurosurgery, v 96(1), pp 41-49
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001378958600023
- Scopus ID
- 2-s2.0-85212991067
- Other Identifier
- 991022155290704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery