Journal article
Vestibular Schwannoma Koos Grade II International Study of Active Surveillance Versus Stereotactic Radiosurgery: The VISAS-K2 Study
Neurosurgery, v 96(1), pp 50-58
01 Jan 2025
PMID: 39503444
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND AND OBJECTIVES:This study assessed the efficacy and safety of stereotactic radiosurgery (SRS) in comparison with watchful waiting for managing Koos grade II vestibular schwannomas (VS). METHODS:A retrospective, multicentric analysis was conducted, focusing on patients with Koos grade II VS who either received SRS (SRS group) or were observed (observation group). To ensure comparability between groups, propensity score matching was used, including factors such as demographic characteristics, tumor dimensions, and hearing assessments. The primary end points examined were tumor control, maintenance of serviceable hearing, and neurological outcomes. RESULTS:A total of 92 patients were equally matched across both cohorts, with a median follow-up of 37 months for the SRS group and 27.5 months for those observed. The SRS cohort exhibited superior tumor control over observation across 3, 5, and 8 years, achieving a 100% control rate vs 47.9%, 40.1%, and 34.3% for the observation group at these time intervals, respectively (P < .001). Serviceable hearing preservation rates were comparable between the 2 groups throughout 3, 5, and 7 years (72.9% for SRS vs 65.4% for observation at 3 years; P = .86). Moreover, SRS management correlated with a lower incidence of vestibular symptoms (odds ratio = 0.11, P = .002), with no significant disparity in the deterioration of cranial nerve (CN) V or CN VII functions. Notably, the likelihood of experiencing any CN impairment was significantly diminished in the SRS cohort (odds ratio = 0.47, P = .04). CONCLUSION:For patients with Koos grade II VS, SRS offers superior tumor control rate and a lower risk of CN dysfunction without sacrificing hearing preservation.
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Details
- Title
- Vestibular Schwannoma Koos Grade II International Study of Active Surveillance Versus Stereotactic Radiosurgery: The VISAS-K2 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 50-58
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001378958600018
- Scopus ID
- 2-s2.0-85212992146
- Other Identifier
- 991022154810404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery