Rates of Recurrence, Residual Tumor, and Reoperation and SRS in a Consecutive Series of 540 Patients with Acoustic Neuroma, 1988 to 2005

Abstract

Introduction: Presently there are several options available to patients with acoustic tumors. Information concerning recurrences following treatment of acoustic tumors is important to the decision-making process and informed consent. A consecutive series of 540 patients with acoustic tumors who underwent resection as primary treatment were followed for a mean of 7.5 years. Results with regard to residual and recurrent tumors are reported and analyzed. Methods: In addition to maintaining a database (Microsoft Access) concerning this group of patients, additional follow-up visits, telephone questionnaires, correspondence from referring physicians, and 1-, 3-, and 6-year MRI scans were used to obtain results. Results: Of 540 patients analyzed, we were able to document 8 recurrent or residual tumors, 3 of which were re-resected. Conclusions: There continues to be a paucity of literature documenting the frequency of residual or recurrent tumors requiring treatment following attempted complete microsurgical resection. A low incidence of tumor recurrence was noted after successful microresection of acoustic tumors in this series. Enhancing lesions in the distal internal auditory canal (IAC) on MRI at 1 year postop are predictive of growing recurrent acoustic neuromas at 3 years. A negative MRI at 1 year postop is highly predictive of no recurrence at 3 and 6 years.