{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T05:02:10Z","timestamp":1749358930907},"reference-count":46,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"\nOBJECTIVE<\/jats:title>\nDue to the heterogeneous definitions of tumor regrowth and various tumor volume distributions, the nature of small remnants after vestibular schwannoma (VS) surgery and the appropriate timing of adjuvant stereotactic radiosurgery for these remnants remain unclear. In this study, the growth potential of small remnants (< 1 cm3<\/jats:sup>) after VS surgery was compared with that of treatment-na\u00efve (TN) small VSs.<\/jats:p>\n<\/jats:sec>\n\nMETHODS<\/jats:title>\nThis retrospective single-center study included 44 patients with VS remnants following subtotal resection (STR) of a large VS (remnant group) and 75 patients with TN VS (< 1 cm3<\/jats:sup>; TN group). A 20% change in tumor volume over the imaging interval indicated radiographic progression or regression. Tumor progression-free survival (TPFS) rates were estimated using the Kaplan-Meier method.<\/jats:p>\n<\/jats:sec>\n\nRESULTS<\/jats:title>\nIn the remnant group, the mean preoperative tumor volume was 13.8 \u00b1 9.0 cm3<\/jats:sup> and the mean tumor resection rate was 95% \u00b1 5%. The mean tumor volume at the start of the observation period did not differ significantly between the two groups (remnant vs TN: 0.41 \u00b1 0.29 vs 0.34 \u00b1 0.28 cm3<\/jats:sup>, p = 0.171). The median periods until tumor progression was detected were 15.1 (range 4.9\u201376.2) months and 44.7 (range 12.6\u201393.2) months in the TN and remnant groups, respectively. In the remnant group, the TPFS rates were 74% and 70% at 3 and 5 years after the surgery, respectively, compared with 59% and 47% in the TN group. The log-rank test demonstrated a significant difference (p = 0.008) in the TPFS rates between the two groups. Furthermore, 42 patients each from the remnant and TN groups were matched based on tumor volume. TPFS was significantly longer in the remnant group than in the TN group (3-year rates, 77% vs 62%; 5-year rates, 73% vs 51%; p = 0.02). In the remnant group, 18% of the tumor remnants demonstrated regression during follow-up, compared with 9% in the TN group, but this intergroup difference was not significant (p = 0.25).<\/jats:p>\n<\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nThis study demonstrated that the growth potential of small VS remnants was lower than that of TN tumors. Observing for small remnants may be appropriate after STR of a large VS. Given the risk of tumor regrowth, careful observation using MRI should be mandatory during follow-up.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.10.jns22680","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T10:18:36Z","timestamp":1671790716000},"page":"423-431","source":"Crossref","is-referenced-by-count":1,"title":["Growth potential of small residual tumors after vestibular schwannoma surgery: comparison between remnants and the natural history of small tumors"],"prefix":"10.3171","volume":"139","author":[{"given":"Yoshinori","family":"Higuchi","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeki","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyoko","family":"Aoyagi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba;"},{"name":"Department of Neurosurgery, Chiba Cerebral and Cardiovascular Center, Ichihara;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Origuchi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Horiguchi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Serizawa","sequence":"additional","affiliation":[{"name":"Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iwao","family":"Yamakami","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Seikeikai Chiba Medical Center, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Iwadate","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Neurol Neurosurg Psychiatry","first-page":"453","article-title":"Removal of large acoustic neurinomas (vestibular schwannomas) by the retrosigmoid approach with no mortality and minimal morbidity","volume":"75","author":"Yamakami I","year":"2004","unstructured":"Yamakami I, Uchino Y, Kobayashi E, Yamaura A, Oka N. 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