2025 Proffered Presentations
S263: GAMMA KNIFE SURGERY FOR PATIENTS WITH JUGULAR FORAMEN SCHWANNOMAS: SYSTEMATIC REVIEW AND META-ANALYSIS
Filipe Ribeiro1; Lucca Palavani2; Marcelo Porto Sousa3; José Victor Santos4; Christian Fukunaga5; Helvécio Filho6; Davi Coelho7; Yasmin Silva8; Márcio Ferreira9; Filipi F Andreão3; Mariana Dagios1; Herika Negri10; 1Barão de Mauá, Faculty of Medicine; 2Max Planck University Center, Indaiatuba, São Paulo, Brazil; 3Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 4University Center Estácio of Ceará, Faculty of Medicine, Iguatu, CE, Brazil; 5Faculty of Medicine, FMABC University Center, São Paulo, Brazil; 6Faculty of Medicine, University of Fortaleza, Fortaleza, Brazil; 7CEUMA University, Imperatriz, Brazil; 8University of Debrecen, Debrecen, Hungary; 9Department of Neurosurgery, Lenox Hill Hospital/Northwell Health, New York, NY, USA; 10Department of Neurosurgery, Mayo Clinic Hospital, Arizona, United States
Introduction: Resection has been the primary course of treatment for patients with jugular foramen schwannoma (JFS). However, most patients develop neurological deterioration as a result of mechanical cranial nerve injuries that occur during surgery. Stereotactic radiosurgery (SRS) has emerged as an effective minimally invasive treatment for various brain tumors. However, there is little information about the outcomes of patients with JFSs treated with SRS due to the rarity of the disease. Therefore, our aim was to evaluate the safety and efficacy of SRS in patients with JFSs.
Methods: We searched Medline, Embase, Web of Science databases following PRISMA guidelines. We used single proportion analysis with 95% confidence intervals under a random-effects model, I2 to assess heterogeneity, and Baujat and sensitivity analysis to address high heterogeneity. Eligible studies included those with ≥4 patients treated with gamma knife surgery for patients with jugular foramen schwannomas.
Results: From 955 initially identified studies, 15 were selected, involving 301 patients, with a median follow-up of 33 months. The combined analysis showed a 98% (CI: 95% - 100%) rate of tumor control. Regarding partial resection, the pooled analysis confirmed a 74% rate (CI: 29% to 100%). The pooled analysis confirmed a 16% neurologic deficits rate (CI: 3% to 33%) and an 11% postoperative cranial nerves deficit rate (CI: 3% to 24%). Regarding complications, the pooled analysis confirmed a 7% complications rate (CI: 2% to 13%).
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Figure 1 - tumor control.
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Figure 2 - Partial resection.
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Figure 3 - Neurologic deficits
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Figure 4 - Complications
Conclusion: Based on the results, our meta-analysis identified that SRS in patients with JFS is safe and effective, considering the tumor control rate, neurological deficit rate, postoperative cranial deficits rate, and complications rate.