Author Topic: Article Review: Observation, radiosurgery or microsurgery?  (Read 1287 times)


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Article Review: Observation, radiosurgery or microsurgery?
« on: January 13, 2017, 09:29:53 pm »
“radiosurgery is the optimal choice for small- and medium-sized ANs”

This interesting quote is from “How to Address Small- and Medium-Sized Acoustic Neuromas with Hearing: A Systematic Review and Decision Model” by Weiming Liu et al from 2015. (click on "Download full-text PDF")

The article examines the scenario of patients with useful residual hearing and tumors ≤3.0 cm.

"Currently, decision making has been based primarily on the doctor's experience and the patient's choice"

Their analysis scored different possible outcomes. "A patient without complications, in whom the tumor is controlled, and whose useful hearing is maintained was considered to be a perfect outcome, with a score of 1.00. The worst outcomes were death or survival with severe complications, which were scored as 0 points."

The results of their analysis is shown below:

It's a bit difficult to read, but the summary is that wait-and-scan scored 0.64, radiosurgery 0.69 (0.68 in the abstract) and microsurgery 0.32 (0.28 in the abstract). The differences between Figure 1 and the abstract indicates a last-minute revision to one or the other.

What is interesting is that observation and radiosurgery scored very similar numbers. I wonder how the scores would change if the follow-up MRI demonstrated no growth, which is the majority of cases?

Summary: Observation or radiosurgery are the best options for tumors ≤3.0 cm with useful hearing.