Long‐Term Quality of Life of Vestibular Schwannoma Patients: A Longitudinal Analysis

Abstract

Objective Vestibular schwannoma management aims to maintain optimal quality of life (QoL) while preventing severe sequelae of the tumor or its treatment. This study assessed long-term QoL of patients with vestibular schwannoma in relation to treatment modality and decisional regret. Study Design A longitudinal study, in which clinical and QoL data were used that were cross-sectionally acquired in 2014 and again in 2020 from the same patient group. Setting A tertiary expert center for vestibular schwannoma care in the Netherlands. Methods QoL was measured by the Penn Acoustic Quality of Life (PANQOL) scale. Changes in time were assed using a linear mixed model. In addition, the Decision Regret Scale was analyzed. Results Of 867 patients, 536 responded (62%), with a median follow-up of 11 years. All PANQOL subdomain scores remained stable over time and did not exceed minimal clinically important difference (MCID) levels. Time since treatment did not affect QoL. Patients had comparable average QoL scores and proportions of patients with changing QoL scores (ie, exceeding the MCID) over time, irrespective of the received initial treatment. Female patients and those who required salvage therapy (either by radiotherapy or surgery) reported a lower QoL. The latter patient group reported the highest decisional regret. Conclusion On average, the long-term QoL of patients with vestibular schwannoma is comparable for patients under active surveillance and those who have received active treatment, and it remains stable over time. This suggests that, on average, preservation of QoL of patients with vestibular schwannoma is feasible when adequately managed.

Decision Making for Active Surveillance in Vestibular Schwannoma

“…These circumstances set the stage for the over treatment of a benign condition. Not only can unnecessary treatment have long-lasting impacts on patient’s quality of life but also it may have implications on healthcare waste and spending ( 17 – 19 ).…”

Vestibular Complaints Impact on the Long-Term Quality of Life of Vestibular Schwannoma Patients

“…This cross-sectional survey study was part of a more extensive study on long-term vestibular schwannoma QoL outcomes (13).…”

“…This cross-sectional survey study was part of a more extensive study on long-term vestibular schwannoma QoL outcomes ( 13 ). The study was performed at a tertiary university hospital and expert center for vestibular schwannoma.…”

Trading mental and physical health in vestibular schwannoma treatment decision

“…Furthermore, some symptoms might be accentuated in comparison to microsurgery ( 15 , 16 ). Recent studies do not detect any QoL differences when comparing patients following different treatment strategies ( 14 , 17 , 18 ). However, most studies mainly relate to physical health (PH) aspects of QoL.…”

“…It has been hypothesized that microsurgery may confer an advantage with regard to patient’s MH, relating to the psychological benefit of “cure” from tumor removal ( 17 ). In general, however, QoL data in VS treatment differentiating between PH and MH is scarce ( 14 , 17 , 18 , 22 ).…”