Impact of Aspirin and Other NSAID Use on Volumetric and Linear Growth in Vestibular Schwannoma

John P. Marinelli, Katherine A. Lees, Nicole M. Tombers, Christine M. Lohse, Matthew L. Carlson

Research output: Contribution to journalReview articlepeer-review

Abstract

Objectives: Conflicting research exists surrounding the utility of aspirin to prevent tumor growth in the medical management of vestibular schwannoma (VS). Recent studies demonstrated no association between aspirin and VS growth using linear tumor measurements. Given the heightened sensitivity of volumetric analyses to monitor tumor growth, the current study was conceived with the chief objective of assessing the association between aspirin or other nonsteroidal anti-inflammatory drug (NSAID) use and VS growth using volumetric analyses. Study Design: Retrospective review. Setting: Tertiary referral center. Subjects and Methods: A total of 361 patients totaling 1601 volumetrically analyzed magnetic resonance imaging studies who underwent initial observation since January 1, 2003. Results: In total, 123 (35%) patients took 81 mg aspirin daily, 23 (7%) took 325 mg aspirin daily, and 41 (11%) reported other NSAID use. Among those taking aspirin, 112 (72%) exhibited volumetric tumor growth during observation compared to 33 (80%) among other NSAID users and 137 (67%) among nonaspirin users. Patients taking aspirin or other NSAIDs were significantly older at time of diagnosis (median, 66 vs 56 years; P <.001). Neither aspirin use (hazard ratio [HR], 0.96; P =.73) nor other NSAID use (HR, 1.39; P =.081) was significantly associated with a reduced risk of volumetric tumor growth. These results were similar following age adjustment (P =.81 and.087, respectively). When separating aspirin users by 81-mg or 325-mg dosing, neither group exhibited a reduced risk of growth (P =.95 and.73, respectively). Conclusion: Despite promising initial results, the preponderance of existing literature suggests that aspirin and other NSAID use does not prevent tumor growth in VS.

Original languageEnglish (US)
Pages (from-to)1081-1086
Number of pages6
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume160
Issue number6
DOIs
StatePublished - Jun 1 2019
Externally publishedYes

Keywords

  • acoustic neuroma
  • aspirin
  • growth
  • NSAID
  • vestibular schwannoma
  • volumetric analysis

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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