Prospective Study of Disease-Specific Quality-of-Life in Sporadic Vestibular Schwannoma Comparing Observation, Radiosurgery, and Microsurgery.

Autor:	Carlson ML; Department of Otolaryngology-Head and Neck Surgery.; Department of Neurologic Surgery., Barnes JH; Department of Otolaryngology-Head and Neck Surgery., Nassiri A; Department of Otolaryngology-Head and Neck Surgery., Patel NS; Department of Otolaryngology-Head and Neck Surgery., Tombers NM; Department of Otolaryngology-Head and Neck Surgery., Lohse CM; Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota., Van Gompel JJ; Department of Otolaryngology-Head and Neck Surgery.; Department of Neurologic Surgery., Neff BA; Department of Otolaryngology-Head and Neck Surgery., Driscoll CLW; Department of Otolaryngology-Head and Neck Surgery.; Department of Neurologic Surgery., Link MJ; Department of Otolaryngology-Head and Neck Surgery.; Department of Neurologic Surgery.
Jazyk:	angličtina
Zdroj:	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2021 Feb 01; Vol. 42 (2), pp. e199-e208.
DOI:	10.1097/MAO.0000000000002863
Abstrakt:	Background: Previous cross-sectional studies analyzing quality of life (QOL) outcomes in patients with sporadic vestibular schwannoma (VS) have shown surprisingly little difference among treatment modalities. To date, there is limited prospective QOL outcome data available comparing baseline to posttreatment scores. Study Design: Prospective longitudinal study using the disease-specific Penn Acoustic Neuroma Quality of Life (PANQOL) scale. Setting: Large academic skull base center. Patients: Patients diagnosed with unilateral VS who completed a baseline survey before treatment and at least one posttreatment survey. Main Outcome Measures: Change in PANQOL scores from baseline to most recent survey. Results: A total of 244 patients were studied, including 78 (32%) who elected observation, 118 (48%) microsurgery, and 48 (20%) stereotactic radiosurgery. Patients who underwent microsurgery were younger (p < 0.001) and had larger tumors (p < 0.001) than those who underwent observation or radiosurgery; there was no significant difference in duration of follow-up among management groups (mean 2.1 yrs; p = 0.28). When comparing the total PANQOL score at baseline to the most recent survey, the net change was only -1.1, -0.1, and 0.3 points on a 100-point scale for observation, microsurgery, and radiosurgery, respectively (p = 0.89). After multivariable adjustment for baseline features, there were no statistically significant changes when comparing baseline to most recent scores within each management group for facial function, general health, balance, hearing loss, energy, and pain domains or total score. However, the microsurgical group experienced a 10.8-point improvement (p = 0.002) in anxiety following treatment, compared with 1.5 (p = 0.73) and 5.3 (p = 0.31) for observation and radiosurgery, respectively. Conclusions: In this prospective longitudinal study investigating differences in QOL outcomes among VS treatment groups using the disease-specific PANQOL instrument, treatment did not modify QOL in most domains. Microsurgery may confer an advantage with regard to patient anxiety, presumably relating to the psychological benefit of "cure" from having the tumor removed. Competing Interests: The authors report no relevant conflicts of interest in submitting this article for publication. (Copyright © 2020, Otology & Neurotology, Inc.)
Databáze:	MEDLINE
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