World neurosurgery
October 15, 2026 · via Europe PMC
Natural History of Residual Vestibular Schwannoma After Incomplete Microsurgical Resection: Delayed Progression During Long-Term Surveillance.
Shawarba J, Listmann M, Khalaveh F, Matula C, Roessler K
AI summary — for doctors, generated from the abstract only
More than half of residual vestibular schwannomas progressed over long surveillance, often after 5 years.
What was studied
Retrospective single-center cohort of 22 patients with residual tumor after microsurgery (median follow-up 84 months), defining progression as growth of at least 2 mm.
Key findings
- 12 patients (55%) progressed, 5 of them (42%) more than 5 years after surgery; 3 remnants regressed
- Median progression-free survival was 81 months; 77% at 3 years and 68% at 5 years
- Residual size was not significantly associated with progression, and 6 patients (27%) needed secondary treatment
Clinical relevance
Supports MRI surveillance beyond 5 years after planned incomplete resection.
Who should care
Limitations
Very small cohort from 194 operated patients, many excluded for incomplete imaging, so selection bias and imprecision are likely; it does not compare strategies.
Remnants can grow late, so long follow-up is reasonable.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
BACKGROUND
Deliberate incomplete resection of vestibular schwannoma (VS) is increasingly accepted to preserve cranial nerve function, but the long-term behaviour of remnants remains uncertain. We describe the natural history of residual VS during extended radiological surveillance.
METHODS
Of 194 patients who underwent VS microsurgery at a single centre between 2013 and 2019, 68 had complete pre- and postoperative MRI and formed the study cohort; 22 (32%) had a residual tumour on baseline MRI and constituted the analysis population. Progression was defined as a ≥2-mm increase in maximum linear diameter. Progression-free survival (PFS) was estimated with the Kaplan-Meier method; residual size (<10 mm vs. ≥10 mm) was explored with log-rank tests and Cox regression.
RESULTS
Median age was 56 years (range, 25-72), 13 patients (59%) were female, and median follow-up was 84 months (range, 37-144). Twelve patients (55%) showed progression, 5 of them (42%) more than 5 years after surgery; 3 remnants regressed. Median PFS was 81 months (95% CI, 35-127); PFS was 77% at 3 years and 68% at 5 years. Residual size was not significantly associated with progression (log-rank p = 0.48; hazard ratio for ≥10 mm, 1.71; 95% CI, 0.38-7.79). Six patients (27%) received secondary treatment (surgery, n = 4; radiosurgery, n = 2).
CONCLUSIONS
In this small cohort, more than half of residual VS progressed, often beyond 5 years. These data support the feasibility of MRI surveillance extending beyond 5 years after incomplete resection but do not establish its comparative safety or effectiveness.
DOI
10.1016/j.wneu.2026.125421
PMID
42880708
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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