• Daniela Stastna, Robert Macfarlane, Patrick Axon, Richard Mannion, Neil Donnelly, James R Tysome, Rajeev Mathews, Mathew Guilfoyle, Daniele Borsetto, Ronie Jayapalan, Indu Lawes, Juliette Buttimore, and Manohar Bance.
• Department of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK.
• Neurosurgery. 2024 Oct 11.

Background And ObjectivesSurveillance studies offer sparse knowledge of predictors of future growth in sporadic vestibular schwannomas (VS).Our aim was identification of these risk factors. We propose a scoring system to estimate the risk of growth in sporadic vestibular schwannoma.MethodsThis retrospective study is based on the demographic and radiological data of 615 adult patients under the surveillance for single VS in our center. Univariate analysis, multivariate regression, and Kaplan-Meier analysis were used when appropriate. The regression coefficient-based "VS score" was calculated based on Cox proportional-hazards regression.ResultsDuring surveillance, 285 tumors (46%) remained stable, 314 tumors (51%) grew, and 16 tumors (3%) shrank. The significant risks factors for future growth identified both in univariate and multivariate analyses were younger age at onset, cystic morphology, larger tumor volume, and cisternal location (as per Hannover grade). The proportion of growing tumors was 40%, 75%, and 96% among the homogeneous VS, primary cystic, and VS transformed to cystic, respectively. Moreover, tumor growth during the 1st year was significant predictor of continuous growth. Our "VS score" includes variables such as age, sex, morphology, and Hannover grade. The score extends between -3 and 6 points. Kaplan-Meier, confusion matrix, and receiver operating characteristic analysis proved high accuracy of our scoring model.ConclusionOur retrospective study revealed that younger age, cystic morphology, cisternal extent, larger volume, and growth during 1st year were strong predictors of future growth. Moreover, we propose a scoring system that accurately estimates the risks of future tumor growth.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.

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