Macrophage Density Predicts Facial Nerve Outcome and Tumor Growth after Subtotal Resection of Vestibular Schwannoma

Journal of Neurological Surgery. Part B, Skull Base
Christopher S GraffeoJamie J Van Gompel

Abstract

Introduction  Vestibular schwannoma (VS) behavior following subtotal resection (STR) is highly variable. Overall progression rates have been reported as high as 44%, and optimal treatment is controversial. Correspondingly, identification of a reliable clinical or pathologic marker associated with progression after STR would help guide decision-making. Methods  A prospectively maintained institutional VS registry from 1999 to 2014 was retrospectively reviewed for sporadic VS patients who underwent primary STR without preceding stereotactic radiosurgery (SRS) by a single neurosurgery-neurotology team. Primary endpoints included tumor progression and postoperative facial nerve function. Pathologic specimens were stained for Ki67, CD68, S100, and SOX10 and were quantitated by digital imaging analysis. Macrophage density was defined as the ratio of CD68 + macrophages to S100 + macrophages and Schwannian tumor cells. Clinical outcomes were correlated with pathologic markers. Results  Forty-six patients met the study inclusion criteria. Thirteen (28%) progressed during a mean 57 months of follow-up (range 15-149). Favorable postoperative facial nerve function (House-Brackmann I-II) was achieved in 37 (80%). CD68 + cells were present a...Continue Reading

Citations

Sep 15, 2020·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Andrew J BowenJohn I Lane
May 29, 2021·BMJ Case Reports·Frank Kouzel MartinezMichael J Link
Nov 13, 2021·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Lucas P CarlstromMichael J Link

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