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Late-Breaking Scientific Oral Presentations

Otology/Neurotology

Session: Late Breaking Scientific Orals 2

Post-Resection Recurrence in Neurofibromatosis Type 2-Associated Versus Sporadic Vestibular Schwannomas

Sunday, October 12, 2025
8:54 AM - 9:00 AM EDT
Location: 107-108
Disclosure(s):
Stephanie M. Younan, MPH, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Connie Chang-Chien, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: While Neurofibromatosis type 2 (NF2)-associated vestibular schwannomas (VS) are considered aggressive with high recurrence rates, robust matched-cohort data on post-resection outcomes remain limited. This study provides insights into tumor recurrence and post-operative complications following planned subtotal surgical resection in NF2-associated versus sporadic VS patient cohorts.

Methods: This retrospective cohort study at a single tertiary center included VS patients who had undergone planned subtotal surgical resection between 2004 and 2024. Cohort-matching was applied in a 1:3 ratio, balancing age, sex, and initial tumor size between NF2 and sporadic VS cohorts. Primary outcomes included tumor recurrence, 30-day surgical/medical complications, and recurrence-free survival using Kaplan-Meier analysis.

Results: Among 374 VS patients who underwent STR, there were 21 NF2 patients. Baseline characteristics, including mean age at surgery (NF2 43 yrs; sporadic 45 yrs), tumor size (Koos Grade IV), and treatment modalities, were comparable between the two cohorts. NF2 patients had higher rates of receiving prior radiation (20% vs. 6%; p=0.033), but lower rates of post-operative adjuvant radiation (14.3% vs. 54.7%; p=0.013). NF2 VS patients had significantly increased recurrence rates (p=0.0215) after subtotal resection. Matched cohorts showed no significant difference in 30-day surgical (p=0.264) or medical (p=0.541) complications. Paradoxically, despite similar residual tumor burden, higher rates of the index surgery being a salvage treatment, and significantly lower usage of adjuvant radiation, NF2 VS exhibited a significantly longer median time to recurrence than sporadic VS (741 days vs 205 days; p=0.0205).

Conclusions: NF2-associated VS patients have high rates of recurrence after subtotal resection. Despite receiving significantly lower rates of post-operative adjuvant radiation, their median time to recurrence is about two years longer than that of sporadic VS. These findings may be useful for evidence-based patient counseling, adjuvant therapy, and surveillance protocols.

    Presenting Author(s)

  • Stephanie M. Younan, MPH, BS

    Medical Student
    University of California - San Francisco
    San Francisco, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • CC

    Connie Chang-Chien, BS

    Medical Student
    University of California - San Francisco
    San Francisco, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Lourdes Kaufman, BA

    Medical Student
    UCSF Department of Otolaryngology-Head and Neck Surgery
    San Francisco, California, United States

    Disclosure information not submitted.

  • RR

    Rithvik Ramesh, BA

    University of California - San Francisco, United States

    Disclosure information not submitted.

  • NA

    Nadeem Al-Adli, MD

    University of California - San Francisco, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Ramin A. Morshed, MD

    Assistant Professor
    University of California - San Francisco
    San Francisco, CA, United States

    Disclosure information not submitted.

  • Nicole T. Jiam, MD

    Otology, Neurotology & Skull Base Surgery
    University of California - San Francisco
    San Francisco, CA, United States

    Disclosure information not submitted.