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Quality of Life in 807 Patients with Vestibular Schwannoma: Comparing Treatment Modalities.

Authors
  • Soulier, Géke1
  • van Leeuwen, Bibian M1
  • Putter, Hein2
  • Jansen, Jeroen C1
  • Malessy, Martijn J A3
  • van Benthem, Peter Paul G1
  • van der Mey, Andel G L1
  • Stiggelbout, Anne M4
  • 1 1 Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands. , (Netherlands)
  • 2 2 Department of Medical Statistics, Leiden University Medical Center, Leiden, the Netherlands. , (Netherlands)
  • 3 3 Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands. , (Netherlands)
  • 4 4 Department of Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands. , (Netherlands)
Type
Published Article
Journal
Otolaryngology
Publisher
SAGE Publications
Publication Date
Jul 01, 2017
Volume
157
Issue
1
Pages
92–98
Identifiers
DOI: 10.1177/0194599817695800
PMID: 28319458
Source
Medline
Keywords
License
Unknown

Abstract

Objective In vestibular schwannoma treatment, the choice among treatment modalities is controversial. The first aim of this study was to examine the quality of life of patients with vestibular schwannoma having undergone observation, radiation therapy, or microsurgical resection. The second aim was to examine the relationship between perceived symptoms and quality of life. Last, the association between quality of life and time since treatment was studied. Study Design Cross-sectional study. Setting Tertiary referral center. Subjects and Methods A total of 1208 patients treated for sporadic vestibular schwannoma between 2004 and 2014 were mailed the disease-specific Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire and additional questions on symptoms associated with vestibular schwannoma. Total and domain scores were calculated and compared among treatment groups. Propensity scores were used, and results were stratified according to tumor size to control for potential confounders. Correlations were calculated to examine the relationship between self-reported symptoms and quality of life, as well as between quality of life and time since treatment. Results Patients with small tumors (≤10 mm) under observation showed a higher PANQOL score when compared with the radiation therapy and microsurgical resection groups. A strong negative correlation was found between self-reported symptoms and quality of life, with balance problems and vertigo having the largest impact. No correlation was found between PANQOL score and time since treatment. Conclusion This study suggests that patients with small vestibular schwannomas experience better quality of life when managed with observation than do patients who have undergone active treatment.

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