Scoring System Assessing Risks of Growth in Sporadic Vestibular Schwannoma.

IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY
Daniela Stastna, Robert Macfarlane, Patrick Axon, Richard Mannion, Neil Donnelly, James R Tysome, Rajeev Mathews, Mathew Guilfoyle, Daniele Borsetto, Ronie Jayapalan, Indu Lawes, Juliette Buttimore, Manohar Bance
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引用次数: 0

Abstract

Background and objectives: Surveillance studies offer sparse knowledge of predictors of future growth in sporadic vestibular schwannomas (VS).Our aim was identification of these risk factors. We propose a scoring system to estimate the risk of growth in sporadic vestibular schwannoma.

Methods: This retrospective study is based on the demographic and radiological data of 615 adult patients under the surveillance for single VS in our center. Univariate analysis, multivariate regression, and Kaplan-Meier analysis were used when appropriate. The regression coefficient-based "VS score" was calculated based on Cox proportional-hazards regression.

Results: During surveillance, 285 tumors (46%) remained stable, 314 tumors (51%) grew, and 16 tumors (3%) shrank. The significant risks factors for future growth identified both in univariate and multivariate analyses were younger age at onset, cystic morphology, larger tumor volume, and cisternal location (as per Hannover grade). The proportion of growing tumors was 40%, 75%, and 96% among the homogeneous VS, primary cystic, and VS transformed to cystic, respectively. Moreover, tumor growth during the 1st year was significant predictor of continuous growth. Our "VS score" includes variables such as age, sex, morphology, and Hannover grade. The score extends between -3 and 6 points. Kaplan-Meier, confusion matrix, and receiver operating characteristic analysis proved high accuracy of our scoring model.

Conclusion: Our retrospective study revealed that younger age, cystic morphology, cisternal extent, larger volume, and growth during 1st year were strong predictors of future growth. Moreover, we propose a scoring system that accurately estimates the risks of future tumor growth.

评估散发性前庭许旺瘤生长风险的评分系统
背景和目的:监测研究对散发性前庭神经分裂瘤(VS)未来生长的预测因素知之甚少。我们提出了一个评分系统来估算散发性前庭神经分裂瘤的生长风险:这项回顾性研究基于本中心监测的 615 名单发前庭神经分裂瘤成年患者的人口统计学和放射学数据。在适当的时候采用单变量分析、多变量回归和卡普兰-梅耶分析。基于回归系数的 "VS 评分 "是根据 Cox 比例危险度回归计算得出的:在监测期间,285 个肿瘤(46%)保持稳定,314 个肿瘤(51%)增大,16 个肿瘤(3%)缩小。在单变量和多变量分析中发现,未来肿瘤生长的重要危险因素包括发病年龄较小、囊性形态、肿瘤体积较大和阴囊位置(根据汉诺威分级)。在同种VS、原发囊性VS和转化为囊性VS中,肿瘤生长的比例分别为40%、75%和96%。此外,肿瘤在第一年的生长情况也能显著预测肿瘤的持续生长。我们的 "VS 评分 "包括年龄、性别、形态和汉诺威分级等变量。得分范围在-3 到 6 分之间。Kaplan-Meier、混淆矩阵和接收者操作特征分析表明,我们的评分模型具有很高的准确性:我们的回顾性研究表明,较小的年龄、囊肿形态、囊腔范围、较大的体积以及第一年的生长情况是未来生长的有力预测因素。此外,我们还提出了一种能准确估计肿瘤未来生长风险的评分系统。
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来源期刊
Neurosurgery
Neurosurgery 医学-临床神经学
CiteScore
8.20
自引率
6.20%
发文量
898
审稿时长
2-4 weeks
期刊介绍: Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery. Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.
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