Patient Characteristics Impacting Adherence to Serial Observation for Vestibular Schwannomas

Area of Science:

• Neurosurgery
• Audiology
• Oncology

Background:

• Vestibular schwannoma (VS) management often involves serial observation.
• Adherence to serial observation is crucial for monitoring tumor growth and neurological function.
• Identifying factors influencing follow-up is essential for optimizing patient care.

Purpose of the Study:

• To investigate patient-specific factors associated with adherence to serial observation in vestibular schwannoma (VS) patients.
• To identify demographic and clinical characteristics that predict follow-up attendance.

Main Methods:

• Retrospective chart review of 507 vestibular schwannoma patients managed with serial observation.
• Logistic regression analysis was employed to determine predictors of follow-up adherence.
• Exclusion criteria included patients under 18, those with prior treatment, bilateral or intralabyrinthine VS, and neurofibromatosis type 2.

Main Results:

• Overall adherence to at least one follow-up visit was 70.6%.
• Patients with private insurance, a racial minority background, worse pure tone audiometry (PTA) averages, and older age at diagnosis were significantly less likely to attend follow-up appointments.
• Odds ratios indicated decreased likelihood of follow-up for these groups.

Conclusions:

• Private insurance, minority status, poorer hearing, and advanced age are associated with reduced follow-up adherence in VS patients on serial observation.
• These findings highlight the need for targeted support strategies for high-risk patient groups to improve serial observation adherence.
• Enhanced patient support may be necessary to ensure consistent monitoring and management of vestibular schwannoma.