ArticleJournal of neuro-oncology2016
Does where you live influence how your vestibular schwannoma is managed? Examining geographical differences in vestibular schwannoma treatment across the United States.
Article in Journal of neuro-oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Socioeconomic disparities in vestibular schwannoma diagnosis and management: A systematic review.Neurosurgical review · 2026Pooled it
- Health-related quality of life in patients with vestibular schwannoma managed with observation, stereotactic radiosurgery or microsurgery: a systematic review and single-arm meta-analysis.Journal of neurology · 2026Pooled it
- Management of sporadic intracanalicular vestibular schwannomas: A critical review and International Stereotactic Radiosurgery Society (ISRS) practice guidelines.Neuro-oncology · 2024Pooled it
- Trial
- Unique Natural History of Very Small Vestibular Schwannoma Substantiates Size Threshold Surveillance.The Laryngoscope · 2026Article
- Cost of Vestibular Schwannoma Treatment: A Systematic Review and Meta-Analysis.Journal of neurological surgery. Part B, Skull base · 2024Article
- Spontaneous Regression of a Large Vestibular Schwannoma: Is Nonoperative Management Reasonable?Brain tumor research and treatment · 2024Article
- The natural history of vestibular schwannoma growth-prospective 40-year data from an unselected national cohort.Neuro-oncology · 2021Article
- Neuro-Ophthalmic Complications of Vestibular Schwannoma Resection: Current Perspectives.Eye and brain · 2021Review
- The Patient-Centered Approach: A Review of the Literature and Its Application for Acoustic Neuromas.Journal of neurological surgery. Part B, Skull base · 2020Article
- Geographical Differences in Intracranial Meningioma Management: Examining 65,973 Patients across the United States.Journal of neurological surgery. Part B, Skull base · 2019Article
- A Cross-Sectional Survey of the North American Skull Base Society Part 3: The State of Lateral Skull Base Surgery Training in North America.Journal of neurological surgery. Part B, Skull base · 2019Article
- An international comparison of diagnostic and management strategies for vestibular schwannoma.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2019Article
- A Cross-sectional Survey of the North American Skull Base Society on Vestibular Schwannoma, Part 2: Perioperative Practice Patterns of Vestibular Schwannoma in North America.Journal of neurological surgery. Part B, Skull base · 2018Article
- A Cross-sectional Survey of the North American Skull Base Society: Current Practice Patterns of Vestibular Schwannoma Evaluation and Management in North America.Journal of neurological surgery. Part B, Skull base · 2018Article
- Review
- Geographic distribution of vestibular schwannomas in West Scotland between 2000-2015.PloS one · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The management of small- to medium-sized vestibular schwannoma (VS) remains controversial. Despite a lack of compelling evidence supporting one treatment modality over others, many providers and institutions remain highly biased toward one particular therapy-microsurgery, radiation, or primary observation. The objective of the current study was to estimate the impact of geography on disease presentation and initial treatment of VS in the United States. An analysis of the Surveillance, Epidemiology, and End Results (SEER) database identified 9761 patients with VS that were managed across the 16 SEER geographic registry areas. Univariate analyses demonstrated strong associations between geographic location and tumor size at diagnosis (P < 0.0001). When analyzing the 6115 subjects with tumors between 0 and 3 cm in size, multivariable models identified strong associations between place of residence and treatment modality (P < 0.0001). These multivariable models demonstrated that in many cases the impact of place of residence on treatment selection was greater than other established variables such as tumor size and age. To our knowledge, this is the first study to evaluate geographic trends in VS patient demographics, tumor size and management in the United States. These data suggest that disease presentation and treatment modality are significantly influenced by regional referral patterns, provider or institutional treatment preferences, and regional availability of subspecialty expertise. Understanding geographic bias is important for patients, referring physicians, and treatment providers alike. Until there is clear evidence supporting one therapy over others, multidisciplinary consultation with a minimum of a neurotologist, neurosurgeon, and radiation oncologist or radiosurgeon should be offered in order to provide balanced counseling and accurate informed consent.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.