Evidence map›Paper›PMID 41162807›Full record

SynthesisJournal of neuro-oncology2025

The relationship between extent of resection, tumor recurrence, and facial nerve outcomes in vestibular schwannoma surgery: a single-institution experience and systematic review.

Sai Chandan Reddy, S Farzad Maroufi, James Feghali, A Karim Ahmed, Melissa Canales, Shaan Bhandarkar, Patrick Kramer, Sarah Segal, Deepa Galaiya, Bryan Ward and 15 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Sai Chandan ReddyDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
S Farzad MaroufiDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
James FeghaliDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
A Karim AhmedDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Melissa CanalesDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Shaan BhandarkarDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Patrick KramerDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sarah SegalDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Deepa GalaiyaDepartment of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bryan WardDepartment of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Wade ChienDepartment of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Charles Della SantinaDepartment of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Daniel Q SunDepartment of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Howard FrancisDepartment of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA.
C Matthew StewartDepartment of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Francis CreightonDepartment of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
John CareyDepartment of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Michael LimDepartment of Neurosurgery, Stanford School of Medicine, Stanford, CA, USA.
Risheng XuDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Justin M CaplanDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Chetan BettegowdaDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Jon WeingartDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Henry BremDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Rafael J TamargoDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Christopher M JacksonDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. cjacks53@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGross surgical resection (GTR) of vestibular schwannomas (VS) is curative, but how surgical intent translates to facial nerve outcomes in practice, however, is incompletely understood. The purpose of this study was to identify factors predicting tumor recurrence in our contemporary VS cohort and explore existing literature regarding extent of resection and facial nerve outcomes.

methodsIn this retrospective study, we reviewed outcomes for 451 VS patients who underwent surgical resection at our institution between July 2016 and April 2024. We collected data on demographics, intraoperative clinical characteristics, and postoperative outcomes. A systematic review of all existing VS literature was conducted to compare rates of GTR to rates of preserved facial nerve function.

resultsA multivariable analysis found that larger tumor size increased the risk of recurrence [hazard ratio (HR): 1.903, 95% confidence interval (CI): 1.163-3.113, p = 0.010] and GTR decreased the risk of recurrence (HR: 0.022, 95% CI: 0.003-0.169, p < 0.001). Additionally, a systematic analysis of data extracted from 75 VS studies showed an inverse relationship between rate of GTR and good facial nerve outcomes, but only in series that reported a rate of at least 75% GTR.

conclusionOur data indicate that the risk of tumor recurrence decreases with GTR. Using rate of GTR as a surrogate for surgical intent in institutional studies, we found that the rate of GTR correlates with facial nerve outcomes only in the most surgically aggressive series. Overall, these data support a strategy individualized to each patient that is refined based on intraoperative findings.

Indexed as

Facial NerveNeoplasm Recurrence, LocalNeuroma, AcousticNeurosurgical ProceduresAdultAgedFacial Nerve InjuriesFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesTreatment OutcomeYoung AdultFacial nerve functionGross total resectionPredictorsRecurrenceVestibular schwannoma

Identifiers

PMID41162807

What OpenQuestion holds

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Registered trials

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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.