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Tytuł:
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Patient Demographics Influencing Vestibular Schwannoma Size and Initial Management Plans.
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Autorzy:
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Ostler B; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Killeen DE; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Reisch J; Department of Clinical Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Barnett S; Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Kutz JW Jr; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Isaacson B; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Hunter JB; Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA. Electronic address: .
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Źródło:
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World neurosurgery [World Neurosurg] 2020 Apr; Vol. 136, pp. e440-e446. Date of Electronic Publication: 2020 Jan 10.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: New York : Elsevier
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MeSH Terms:
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Tumor Burden*
Neuroma, Acoustic/*pathology
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Female ; Humans ; Insurance Coverage/statistics & numerical data ; Insurance, Health/statistics & numerical data ; Male ; Marital Status ; Middle Aged ; Neuroma, Acoustic/therapy ; Patient Care Planning ; Residence Characteristics/statistics & numerical data ; Risk Factors ; Young Adult
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Contributed Indexing:
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Keywords: Acoustic neuroma; Demography; Marriage; Race; Skull base; Treatment outcome; Vestibular schwannoma
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Entry Date(s):
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Date Created: 20200114 Date Completed: 20200406 Latest Revision: 20200408
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Update Code:
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20240105
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DOI:
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10.1016/j.wneu.2020.01.019
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PMID:
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31931234
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Objective: To explore patient demographics as to predicting vestibular schwannoma (VS) size and treatment plan within a single institution.
Methods: Using a large tertiary referral skull base center database, all patients with sporadic VS who presented to the center between 2009 and 2018 were reviewed.
Results: A total of 816 patients with VS over 18 years of age were included. The median age was 56.8 years (range: 18.6-90.9 years). The median tumor diameter at diagnosis was 11.9 mm (range: 0.6-51.1 mm). With multivariate analysis, older age was associated with decreased tumor size (0.23 mm, 95% confidence interval [CI]: 0.17-0.29), whereas married patients had larger tumors (2.5 mm, 95% CI: 0.92-4.09). When comparing observation, radiation, or surgery, older patients are more likely to pursue observation as compared with surgery and radiation (odds ratio [OR]: 1.08, 95% CI: 1.06-1.10 and OR: 1.20, 95% CI: 1.08-1.33), respectively. Married patients were less likely to pursue observation as compared with surgery (OR: 0.49, 95% CI: 0.29-0.82). Each additional mile a patient lives farther from the center increases his or her odds of pursuing treatment (OR: 1.002, 95% CI: 1.001-1.003).
Conclusions: Older age is associated with smaller tumors, whereas married patients have larger tumors at diagnosis as compared with nonmarried patients. Furthermore, married patients are more likely to pursue treatment, specifically surgery, as compared with nonmarried patients, whereas patients who live farther from the center are more likely to pursue treatment.
(Copyright © 2020 Elsevier Inc. All rights reserved.)