Current epidemiology and management trends in acoustic neuroma

OBJECTIVE: The objective of this study was to assess the epidemiology of acoustic neuroma and determine current trends in therapy using tumor registry techniques. STUDY DESIGN: Analysis of a national database. SUBJECTS AND METHODS: The Surveillance Epidemiology and End Results (SEER) database is a national tumor registry that began to identify and abstract benign and borderline tumors of the brain and central nervous system in the year 2004. Coding for International Classification of Diseases for Oncology (ICD-O-3) codes for schwannoma (9560/0) with collaborative staging (CS) coding for acoustic nerve (72.4) was used to identify acoustic neuromas. Demographic data, tumor size, and treatment data were analyzed. RESULTS: A total of 1621 patients with acoustic neuroma were identified, for an incidence rate of 1,1/100,000. Mean age was 53.1 years. Tumors were equally distributed across gender and tumor laterality, with the majority (84%) occurring in Caucasians. Nine hundred sixty-four patients (59.5%) were treated with surgery, whereas 341 (21.0%) were treated with radiation. A total of 1.6 percent received combined therapy over the study period, with the remaining patients receiving either no treatment or unknown therapy. Of tumors less than 2 cm, 27.2 percent were treated with radiotherapy. Statistically significant associations were observed with the increased use of radiotherapy for small (< 2 cm) tumors (P = 0.0001). CONCLUSION: Unlike data from single series, which usually represent individual treatment preferences and techniques, use of SEER data allows for the assessment of demographics and treatment trends at the national level. The results and potential applications are discussed. (C) 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.