Abstract
To assess the contribution of multidisciplinary team meetings (MTM) on vestibular schwannoma management as well as to (1) compare professional compliance to national guidelines and (2) study the percentage of loss to follow-up in cases of conservative management by radiologic observation. A retrospective descriptive study of MTMs held between January 2011 and May 2013 in a tertiary referral center. Patients were classified in three groups according to the MTM decision (observation, surgery or radiotherapy). A total of 363 cases were discussed during the study period (29 months). One hundred and ninety-four decisions (53.4 %) were for conservative management with radiologic observation, 130 (35.8 %) for surgery, and 39 (10.7 %) for radiation therapy. The sex ratio was 0.94, and the patients had a median age of 59 years (range 18–86 years). Most of the vestibular schwannomas (74.2 %) were small (stages I and II). Global concordance between the MTM decision and International Radiosurgery Association guidelines was 88.7 %. Twenty-three percent of the 104 files that were discussed in MTMs between January 2011 and July 2012, for which conservative management was decided, were lost to follow-up by 18 months. Management of vestibular schwannoma remains controversial, but it usually depends on the evolutive status. MTMs improve practice and facilitate the creation and maintenance of local registries. Future studies in MTMs are warranted to evaluate the benefit and evaluated if MTM could optimize long-term follow-up, limiting loss to follow-up in the observation of vestibular schwannomas that may be evolutive.
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Taylor C, Munro AJ, Glynne-Jones R, Griffith C, Trevatt P, Richards M, Ramirez AJ (2010) Multidisciplinary team working in cancer: what is the evidence? BMJ 340:743–745
Irradiation intracrânienne en conditions stéréotaxiques: les schwannomes vestibulaires–Rapport d’évaluation : Tome III. November 2011. www.has-sante.fr, accessed August 15, 2013
Battaglia A, Mastrodimos B, Cueva R (2006) Comparison of growth patterns of acoustic neuromas with and without radiosurgery. Otol Neurotol 27:705–712
Hajioff D, Raut VV, Walsh RM, Bath AP, Bance ML, Guha A et al (2008) Conservative management of vestibular schwannomas: third review of a 10-year prospective study. Clin Otolaryngol 33:255–259
Herwadker A, Vokurka EA, Evans DG, Ramsden RT, Jackson A (2005) Size and growth rate of sporadic vestibular schwannoma: predictive value of information available at presentation. Otol Neurotol 26:86–92
Murphy ES, Suh JH (2011) Radiotherapy for vestibular schwannomas: a critical review. Int J Radiat Oncol Biol Phys 79:985–997
Stangerup SE, Caye-Thomasen P, Tos M, Thomsen J (2006) The natural history of vestibular schwannoma. Otol Neurotol 27:547–552
International RadioSurgery Association (2006) Stereotactic radiosurgery for patients with vestibular schwannomas. Harrisburg: IRSA. http://www.irsa.org/AN%20Guideline.pdf
Koos W, Spetzler RF, Bock FW, Salah S (1976) Microsurgery of cerebellopontine angle tumors. In: Koos WTH, Bock FW (eds) Clinical microneurosurgery. Georg Thieme, Germany, pp 91–112
Propp JM, McCarthy BJ, Davis FG, Preston-Martin S (2006) Descriptive epidemiology of vestibular schwannomas. Neuro Oncol. 8(1):1
Babu R, Sharma R, Bagley JH, Hatef J, Friedman AH, Adamson C (2013) Vestibular schwannomas in the modern era: epidemiology, treatment trends, and disparities in management. J Neurosurg 119(1):121–130
Tringali S, Charpiot A, Ould MB, Dubreuil C, Ferber-Viart C (2010) Characteristics of 629 vestibular schwannomas according to preoperative caloric responses. Otol Neurotol 31(3):467–472
Tringali S, Dubreuil C, Zaouche S, Ferber-Viart C (2008) Are stage IV vestibular schwannomas preoperatively different from other stages? Otol Neurotol 29(1):46–49
Sanna M, Falcioni M, Taibah A, De Donato G, Russo A, Piccirillo E (2002) Treatment of residual vestibular schwannoma. Otol Neurotol 23(6):980–987
Hsu PW, Chang CN, Lee ST, Huang YC, Chen HC, Wang CC, Hsu YH, Tseng CK, Chen YL, Wei KC (2010) Outcomes of 75 patients over 12 years treated for acoustic neuromas with linear accelerator-based radiosurgery. J Clin Neurosci 17(5):556–560
Patel J, Vasan R, van Loveren H, Downes K, Agazzi S (2014) The changing face of acoustic neuroma management in the USA: analysis of the 1998 and 2008 patient surveys from the acoustic neuroma association. Br J Neurosurg 28(1):20–24
Varughese JK, Wentzel-Larsen T, Vassbotn F, Moen G, Lund-Johansen M (2010) Analysis of vestibular schwannoma size in multiple dimensions: a comparative cohort study of different measurement techniques. Clin Otolaryngol 35(2):97–103
Van de Langenberg R, de Bondt BJ, Nelemans PJ, Baumert BG, Stokroos RJ (2009) Follow-up assessment of vestibular schwannomas: volume quantification versus two-dimensional measurements. Neuroradiology 51(8):517–524
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Daveau, C., Zaouche, S., Jouanneau, E. et al. Experience of multidisciplinary team meetings in vestibular schwannoma: a preliminary report. Eur Arch Otorhinolaryngol 272, 3187–3192 (2015). https://doi.org/10.1007/s00405-014-3375-x
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DOI: https://doi.org/10.1007/s00405-014-3375-x