Self-Evaluated Quality of Life and Functional Outcomes After Microsurgery, Stereotactic Radiation or Observation-Only for Vestibular Schwannoma of the Adult Patient: A Systematic Review

Efstathios Papatsoutsos (Lead / Corresponding author), Patrick M. Spielmann

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Objective: To evaluate the impact of different management options on health-related quality of life (HRQoL) in vestibular schwannoma patients.

Data Sources: A systematic search of the Cochrane Database, Database of Abstracts of Reviews of Effectiveness, and the Ovid Medline & EMBASE was performed. English and German language studies published between 1980 and 2015 were considered.

Study Selection: This is a systematic review of HRQoL of patients managed for vestibular schwannoma. Studies in which HRQoL after one management option were evaluated or compared with other managements or with control populations using validated or reliable questionnaires, were included.

Data Extraction: The included studies were independently evaluated by two reviewers. The quality of studies was assessed and graded as per Oxford Centre of Evidence Based Medicine System.

Results: Ten prospective and 29 retrospective studies were identified: microsurgery initially exerted a negative effect on HRQoL but this tended to improve with follow up. Radiotherapy had a less negative effect but with minimal change over follow up. A significant limitation was that studies did not present results stratified by tumor size. Many patients will need active treatment despite the potential for negative effects on their QoL. The concept of a minimal clinically important difference has been introduced into this field and was compared with five studies.

Conclusion: A number of prospective studies are available but none yet with a disease-specific questionnaire. Heterogeneity and the methodological weaknesses of the included studies constitute the principle limitation of this review. The introduction of the minimal clinically important difference should improve the relevance of studies and allow a sensitive comparison of treatments.

Original languageEnglish
Pages (from-to)232-241
Number of pages10
JournalOtology & Neurotology
Volume39
Issue number2
DOIs
Publication statusPublished - Feb 2018

Fingerprint

Acoustic Neuroma
Microsurgery
Quality of Life
Observation
Radiation
Databases
Information Storage and Retrieval
Evidence-Based Medicine
Language
Radiotherapy
Retrospective Studies
Prospective Studies
Therapeutics
Population
Neoplasms
Surveys and Questionnaires
Minimal Clinically Important Difference

Keywords

  • Journal article
  • EQ-5D
  • Glagow Benefit Inventory
  • Health-related quality of life
  • Microsurgery
  • Observation
  • Penn Acoustic Neuroma Quality of Life
  • Questionnaire
  • Short Form-36
  • Stereotractic radiation therapy
  • Vestibular schwannoma
  • Wait and scan

Cite this

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title = "Self-Evaluated Quality of Life and Functional Outcomes After Microsurgery, Stereotactic Radiation or Observation-Only for Vestibular Schwannoma of the Adult Patient: A Systematic Review",
abstract = "Objective: To evaluate the impact of different management options on health-related quality of life (HRQoL) in vestibular schwannoma patients.Data Sources: A systematic search of the Cochrane Database, Database of Abstracts of Reviews of Effectiveness, and the Ovid Medline & EMBASE was performed. English and German language studies published between 1980 and 2015 were considered.Study Selection: This is a systematic review of HRQoL of patients managed for vestibular schwannoma. Studies in which HRQoL after one management option were evaluated or compared with other managements or with control populations using validated or reliable questionnaires, were included.Data Extraction: The included studies were independently evaluated by two reviewers. The quality of studies was assessed and graded as per Oxford Centre of Evidence Based Medicine System.Results: Ten prospective and 29 retrospective studies were identified: microsurgery initially exerted a negative effect on HRQoL but this tended to improve with follow up. Radiotherapy had a less negative effect but with minimal change over follow up. A significant limitation was that studies did not present results stratified by tumor size. Many patients will need active treatment despite the potential for negative effects on their QoL. The concept of a minimal clinically important difference has been introduced into this field and was compared with five studies.Conclusion: A number of prospective studies are available but none yet with a disease-specific questionnaire. Heterogeneity and the methodological weaknesses of the included studies constitute the principle limitation of this review. The introduction of the minimal clinically important difference should improve the relevance of studies and allow a sensitive comparison of treatments.",
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author = "Efstathios Papatsoutsos and Spielmann, {Patrick M.}",
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Self-Evaluated Quality of Life and Functional Outcomes After Microsurgery, Stereotactic Radiation or Observation-Only for Vestibular Schwannoma of the Adult Patient : A Systematic Review. / Papatsoutsos, Efstathios (Lead / Corresponding author); Spielmann, Patrick M.

In: Otology & Neurotology, Vol. 39, No. 2, 02.2018, p. 232-241.

Research output: Contribution to journalReview article

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T1 - Self-Evaluated Quality of Life and Functional Outcomes After Microsurgery, Stereotactic Radiation or Observation-Only for Vestibular Schwannoma of the Adult Patient

T2 - A Systematic Review

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AU - Spielmann, Patrick M.

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N2 - Objective: To evaluate the impact of different management options on health-related quality of life (HRQoL) in vestibular schwannoma patients.Data Sources: A systematic search of the Cochrane Database, Database of Abstracts of Reviews of Effectiveness, and the Ovid Medline & EMBASE was performed. English and German language studies published between 1980 and 2015 were considered.Study Selection: This is a systematic review of HRQoL of patients managed for vestibular schwannoma. Studies in which HRQoL after one management option were evaluated or compared with other managements or with control populations using validated or reliable questionnaires, were included.Data Extraction: The included studies were independently evaluated by two reviewers. The quality of studies was assessed and graded as per Oxford Centre of Evidence Based Medicine System.Results: Ten prospective and 29 retrospective studies were identified: microsurgery initially exerted a negative effect on HRQoL but this tended to improve with follow up. Radiotherapy had a less negative effect but with minimal change over follow up. A significant limitation was that studies did not present results stratified by tumor size. Many patients will need active treatment despite the potential for negative effects on their QoL. The concept of a minimal clinically important difference has been introduced into this field and was compared with five studies.Conclusion: A number of prospective studies are available but none yet with a disease-specific questionnaire. Heterogeneity and the methodological weaknesses of the included studies constitute the principle limitation of this review. The introduction of the minimal clinically important difference should improve the relevance of studies and allow a sensitive comparison of treatments.

AB - Objective: To evaluate the impact of different management options on health-related quality of life (HRQoL) in vestibular schwannoma patients.Data Sources: A systematic search of the Cochrane Database, Database of Abstracts of Reviews of Effectiveness, and the Ovid Medline & EMBASE was performed. English and German language studies published between 1980 and 2015 were considered.Study Selection: This is a systematic review of HRQoL of patients managed for vestibular schwannoma. Studies in which HRQoL after one management option were evaluated or compared with other managements or with control populations using validated or reliable questionnaires, were included.Data Extraction: The included studies were independently evaluated by two reviewers. The quality of studies was assessed and graded as per Oxford Centre of Evidence Based Medicine System.Results: Ten prospective and 29 retrospective studies were identified: microsurgery initially exerted a negative effect on HRQoL but this tended to improve with follow up. Radiotherapy had a less negative effect but with minimal change over follow up. A significant limitation was that studies did not present results stratified by tumor size. Many patients will need active treatment despite the potential for negative effects on their QoL. The concept of a minimal clinically important difference has been introduced into this field and was compared with five studies.Conclusion: A number of prospective studies are available but none yet with a disease-specific questionnaire. Heterogeneity and the methodological weaknesses of the included studies constitute the principle limitation of this review. The introduction of the minimal clinically important difference should improve the relevance of studies and allow a sensitive comparison of treatments.

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KW - Short Form-36

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KW - Wait and scan

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JO - Otology & Neurotology

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ER -