J Neurol Surg B Skull Base 2016; 77 - FP-13-07
DOI: 10.1055/s-0036-1592505

Quality of Life in a Large Series of 807 Patients with Vestibular Schwannoma: Comparing the Three Modalities of Treatment

Géke Soulier 1, Bibian van Leeuwen 1, Radboud Koot 2, Anne Stiggelbout 3, Andel G. L. van der Mey 1
  • 1Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, RC Leiden, The Netherlands
  • 2Department of Neurosurgery, Leiden University Medical Center, RC Leiden, The Netherlands
  • 3Department of Medical Decision Making, Leiden University Medical Center, RC Leiden, The Netherlands

Objective: The aim of the study was to assess quality of life in patients with vestibular schwannoma for the three different treatment modalities: observation, radiation therapy and microsurgical resection.

Methods: Cross-sectional study in a tertiary hospital. All patients consulting our center for the treatment of vestibular schwannoma between the years of 2004 and 2014 were included and mailed the disease-specific Penn Acoustic Neuroma Quality Of Life questionnaire along with supplementary questions on symptoms and sociodemographics. A total instrument score was calculated and compared between treatment groups, using propensity scores and stratification to correct for variables identified as potential confounders.

Results: Of 1,208 potential participants, 807 (67%) returned a fully completed questionnaire. After correction for gender, educational level, presence of a cystic aspect to the lesion and symptoms at diagnosis, patients with small tumors (up to 10 mm) in the observation group experienced significantly better quality of life when compared with radiation therapy and surgical resection (b = −5.91, CI [−11.29, −0.53] and b = −4.64 CI [−8.76, −0.52], respectively).

Conclusion: Our study indicates that vestibular schwannoma patients with small tumors retain better quality of life when treated with observation instead of active treatment. Prospectively designed research using a disease-specific measure is needed however, to demonstrate a causal relationship.