Patient motivation and long-term satisfaction with treatment choice in vestibular schwannoma.

Patient motivation and long-term satisfaction with treatment choice in vestibular schwannoma.

World Neurosurg. 2018 Apr 03;:

Authors: Carlson ML, Tveiten ØV, Lund-Johansen M, Tombers NM, Lohse CM, Link MJ

Abstract
OBJECTIVES: To ascertain primary motivation and long-term satisfaction with treatment selection in patients with vestibular schwannoma (VS).
METHODS: A multicenter, cross-sectional survey was performed. Patients with small- to medium-sized sporadic VS who underwent stereotactic radiosurgery (SRS; N=247), microsurgery (N=144), or observation (N=148) between 1998 and 2008 were surveyed regarding motivation behind treatment selection and hindsight satisfaction with choice of management.
RESULTS: "Physician recommendation" was the most commonly stated reason for modality selection in all three groups. The second and third most common reasons for selecting SRS included "less invasive option than surgery" in 80 (32%) and "less recovery time than surgery" in 16 (6%). The second and third most common reasons for selecting observation included "avoid side-effects of treatment" in 25 (17%) and "symptoms not severe enough to warrant intervention" in 22 (15%). The second and third most common reasons for selecting microsurgery included "do not want tumor in head" in 35 (24%) and "most definitive treatment" in 15 (10%). Overall 232 (96%) of SRS treated patients, 141 (97%) of observed patients, and 121 (85%) of microsurgically treated patients were satisfied with their original decision (P<0.001).
CONCLUSIONS: Motivation behind treatment selection varies between individuals. Those who select observation and SRS commonly reference less invasiveness and lower risk, while those who select microsurgery are commonly motivated by having their tumor physically removed and the more definitive nature of treatment. Post-treatment satisfaction is highest in patients managed with SRS and observation, although all three groups report high levels of satisfaction.

PMID: 29625305 [PubMed - as supplied by publisher]

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