(A835) Impact of Tumor Size and Patient Demographics on Surgical Outcomes in Vestibular Schwannoma Resection

Introduction: Larger vestibular schwannomas present unique challenges during surgical resection, potentially affecting various surgical outcomes. Identifying the relationships between tumor size, patient demographics, and perioperative outcomes is essential to improve risk stratification and surgical planning. This study examines the association between maximum tumor size on MRI and outcomes such as estimated blood loss (EBL), surgical time, and specific patient factors, including sex.

Methods: We conducted a retrospective review of patients undergoing vestibular schwannoma resection at an academic medical center from 2014 to 2024. The primary independent variable was maximum tumor length on MRI. Outcome measures included EBL, surgical time, and demographic variables. Spearman correlation and Kruskal-Wallis tests were used to evaluate associations between tumor size and outcomes, with a focus on statistically significant relationships.

Results: The study revealed significant associations between larger tumor size and several critical outcomes. Larger tumor size was positively correlated with increased EBL (correlation 0.264, p = 0.0023, n = 131) and prolonged surgical time (correlation 0.426, p < 0.0001, n = 110), indicating that larger tumors are associated with more complex, resource-intensive procedures. Additionally, sex (male) was a significant factor influencing EBL (Kruskal-Wallis H = 4.679, p = 0.0305, n = 153), with male patients showing higher EBL during surgery. These findings highlight the combined impact of tumor size and patient sex on perioperative demands and risks.

Conclusions: This study underscores the influence of larger tumor size on increased EBL and extended surgical duration in vestibular schwannoma resections. The association between male sex and higher EBL further emphasizes the need for tailored preoperative planning. These insights can guide surgical teams in anticipating challenges associated with larger tumors and specific patient demographics, enhancing patient safety and surgical efficiency.