Surgery for large vestibular schwannomas: how patients and surgeons perceive quality of life

Nicoucar, Keyvan; Momjian, Shahan; Vader, John‐Paul; Tribolet, Nicolas de

doi:10.3171/jns.2006.105.2.205

Cited by 78 publications

(86 citation statements)

References 32 publications

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“…2,3,7,19,22,31 Our findings and those of Sandooram et al 26 and Di Miao et al 8 are at some variance with the findings of these studies. However, it must be pointed out that in our study we compared the QOL at follow-up with preoperative QOL, whereas in the retrospective studies, the only comparison possible was with values obtained in the general population.…”

Section: Improvement In Qol After Surgerysupporting

confidence: 74%

“…In other studies age had no effect on QOL. 1,6,13,26 Similarly, while some reports showed women to have lower scores than men, 2,14,19,20,22,31 other studies, including our own, showed no difference in SF-36 scores between male and female patients. 1,6,7 Tumor Size Several authors have reported no effect of tumor size on QOL scores.…”

Section: Age and Sexmentioning

confidence: 39%

“…16,19,22 Hence, there is a need for greater emphasis on quality of life (QOL) outcomes (which are patient reported) following surgery for VS. Most of the QOL studies in patients undergoing surgery for VS are retrospective and include patients with small tumors.…”

mentioning

confidence: 99%

“…[1][2][3][4][5][6][7]14,18,21,23,27,28,31 Few studies have reported QOL following surgery for large VS, but even those have mostly been retrospective in nature. 22,25 One of the major deficiencies in QOL studies on VS patients is the lack of a planned prospective comparison between QOL values before and after treatment in large cohorts of patients. 10,11 The few published prospective studies involved patients with small VSs (< 3 cm).…”

mentioning

confidence: 99%

See 3 more Smart Citations

Quality of life following surgery for large and giant vestibular schwannomas: a prospective study

Turel¹,

Thakar²,

Rajshekhar³

2015

JNS

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A discrepAncy between surgeon-assessed and patient-perceived outcomes of vestibular schwannoma (VS) surgery has been reported. 16,19,22 Hence, there is a need for greater emphasis on quality of life (QOL) outcomes (which are patient reported) following surgery for VS. Most of the QOL studies in patients undergoing surgery for VS are retrospective and include patients with small tumors. [1][2][3][4][5][6][7]14,18,21,23,27,28,31 Few studies have reported QOL following surgery for large VS, but even those have mostly been retrospective in nature. 22,25One of the major deficiencies in QOL studies on VS patients is the lack of a planned prospective comparison between QOL values before and after treatment in large cohorts of patients. 10,11 The few published prospective studies involved patients with small VSs (< 3 cm). 20,24,26 To our knowledge there is only one prospective report of QOL in patients with larger tumors (> 3 cm), and that study involved 37 patients. 8None of the reports of QOL in patients with VS have included the proportion of patients showing a minimum clinically important difference (MCID) in the different QOL domains. Surgeons need to know whether an observed change in score represents a clinically important improvement or deterioration rather than merely an inconsequential fluctuation. Differences in scores smaller than the MCID are considered unimportant, regardless of whether statistical significance is reached. To date, such information has not been provided in any published report on QOL in VS patients.We aimed to study the factors affecting QOL in pa- OBJect Prospective studies of quality of life (QOL) are infrequently performed in patients undergoing surgery for vestibular schwannoma (VS). The authors designed this to study to investigate health-related QOL (HR-QOL) in patients with large and giant VSs before and after surgery. methOdS Between January 2009 and December 2012, HR-QOL was measured prospectively before and after surgery, using the 36-Item Short Form Health Survey (SF-36), in 100 patients who underwent surgery for unilateral large or giant VS (tumor size ≥ 3 cm). The Glasgow Benefit Inventory (GBI) was also used to evaluate the effect of surgery. reSultS A total of 100 patients were included in the study (65 men and 35 women). Their mean age (± SD) was 44.2 ± 11.5 years. The preoperative QOL was decreased in all SF-36 domains. A 1-year follow-up evaluation was conducted for all patients (mean 13.5 ± 5.3 months after surgery). The results showed an improvement in HR-QOL compared with preoperative status in all cases, with 63%-85% of patients showing a minimum clinically important difference (MCID) in various domains. A second follow-up evaluation was performed in 51 cases (mean time after surgery, 29.0 ± 8.3 months) and showed sustained improvement in SF-36 scores. In some domains there was further improvement beyond the first follow-up. On the GBI, 87% of patients reported improvement, 1% felt no change, and 12% of patients reported deterioration. cONcluSiONS Patients harboring l...

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Section: Improvement In Qol After Surgerysupporting

confidence: 74%

Section: Age and Sexmentioning

confidence: 39%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Quality of life following surgery for large and giant vestibular schwannomas: a prospective study

Turel¹,

Thakar²,

Rajshekhar³

2015

JNS

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“…3,24,28 Over the past several decades there has been increasing importance placed on patientcentered outcomes, realizing that clinicians commonly underestimate patient impairment, and there is frequent disparity between what health care providers value and what patients prioritize. 21,26 Additionally, treating physicians may not fully appreciate the psychological impact of the diagnosis of a brain tumor, even a benign one, and the significant impact it may have on HRQOL even prior to embarking on a plan of care.…”

Section: Discussionmentioning

confidence: 99%

Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls

Carlson¹,

Tveiten²,

Driscoll

et al. 2015

JNS

179

164

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abbreviatioNs AAO-HNS = American Academy of Otolaryngology-Head and Neck Surgery; CPA = cerebellopontine angle; GBI = Glasgow Benefit Inventory; HRQOL = health-related quality of life; IQR = interquartile range; MCID = minimum clinically important difference; PANQOL = Penn Acoustic Neuroma Quality-of-Life; PROMIS-10 = 10-item Patient-Reported Outcomes Measurement Information System; SF-36 = 36-Item Short Form Health Survey; SRS = stereotactic radiosurgery; VS = vestibular schwannoma. submitted March 18, 2014. accepted November 11, 2014. iNclude wheN citiNg Published online January 2, 2015; DOI: 10.3171/2014.11.JNS14594. disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. Internal departmental funding was used without commercial sponsorship or support. obJect The optimal treatment for sporadic vestibular schwannoma (VS) is highly controversial. To date, the majority of studies comparing treatment modalities have focused on a narrow scope of technical outcomes including facial function, hearing status, and tumor control. Very few publications have investigated health-related quality of life (HRQOL) differences between individual treatment groups, and none have used a disease-specific HRQOL instrument. methods All patients with sporadic small- to medium-sized VSs who underwent primary microsurgery, stereotactic radiosurgery (SRS), or observation between 1998 and 2008 were identified. Subjects were surveyed via postal questionnaire using the 36-Item Short Form Health Survey (SF-36), the 10-item Patient-Reported Outcomes Measurement Information System short form (PROMIS-10), the Glasgow Benefit Inventory (GBI), and the Penn Acoustic Neuroma Quality-of-Life (PANQOL) scale. Additionally, a pool of general population adults was surveyed, providing a nontumor control group for comparison. results A total of 642 respondents were analyzed. The overall response rate for patients with VS was 79%, and the mean time interval between treatment and survey was 7.7 years. Using multivariate regression, there were no statistically significant differences between management groups with respect to the PROMIS-10 physical or mental health dimensions, the SF-36 Physical or Mental Component Summary scores, or the PANQOL general, anxiety, hearing, or energy subdomains. Patients who underwent SRS or observation reported a better total PANQOL score and higher PANQOL facial, balance, and pain subdomain scores than the microsurgical cohort (p < 0.02). The differences in scores between the nontumor control group and patients with VS were greater than differences observed between individual treatment groups for the majority of measures. coNclusioNs The differences in HRQOL outcomes following SRS, observation, and microsurgery for VS are small. Notably, the diagnosis of VS rather than treatment strategy most significantly impacts quality of life. Understanding that a large number of VSs do not grow following discovery, and that intervention does not...

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Quality of life analysis in patients with anterior skull base neoplasms

et al. 2009

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Surgery for large vestibular schwannomas: how patients and surgeons perceive quality of life

Cited by 78 publications

References 32 publications

Quality of life following surgery for large and giant vestibular schwannomas: a prospective study

Quality of life following surgery for large and giant vestibular schwannomas: a prospective study

Long-term quality of life in patients with vestibular schwannoma: an international multicenter cross-sectional study comparing microsurgery, stereotactic radiosurgery, observation, and nontumor controls

Quality of life analysis in patients with anterior skull base neoplasms

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