• Joseph Chang, Jonathan D Breshears, Annette M Molinaro, Penny K Sneed, Michael W McDermott, Philip V Theodosopoulos, and Aaron D Tward.
• Department of Otolaryngology-Head and Neck Surgery, San Francisco, San Francisco, California, U.S.A.
• Laryngoscope. 2019 Mar 1; 129 (3): 743-747.

Objectives/HypothesisTo determine if volumetric growth prior to gamma knife (GK) radiosurgery predicts long-term tumor control.Study DesignRetrospective cohort study.MethodsSporadic vestibular schwannomas (VS) treated with GK between 2002 and 2014 at a single tertiary care center were identified. Patients were included if they had over 6 months of pretreatment observation and over 1.5 years of posttreatment follow-up. Volumetric tumor analysis was performed on T1 postcontrast imaging. Pretreatment and posttreatment volume change was calculated. Tumors with over 20% volume increase were classified as growing.ResultsThere were 62 patients included in this study; 48 had pretreatment growth and 14 had no pretreatment growth. Median tumor volume was 0.58 ± 1.8 cm3 and median follow-up was 3.3 ± 2.0 years. For tumors with and without pretreatment growth, salvage treatment rates were 2% and 7% (P = .35), and posttreatment radiologic stability rates were 73% and 86%, respectively (P = .33). Median pretreatment growth was 27 ± 33% per year for tumors with posttreatment radiographic growth and 18 ± 26% per year for tumors without posttreatment radiographic growth (P = .99).ConclusionsPretreatment growth was not associated with increased salvage treatment or posttreatment radiographic progression rates in VS following GK.Level Of Evidence4 Laryngoscope, 129:743-747, 2019.© 2018 The American Laryngological, Rhinological and Otological Society, Inc.

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