Journal Article

Clinical study on microsurgical treatment for craniopharyngioma in a single consecutive institutional series of 335 patients

Suresh, Vigneyshwar, Song, Laijun, Wang, Guoqing, Zhang, Xiaoyang, Xu, Dingkang, Wang, Fang, Guo, Fuyou, Liu, Xianzhi, Feng, Mengzhao

2018

Overview

•Low morbidity and mortality and the favorable outcomes were achieved in this study.•Tumor recurrence and surgical times contribute to negative resection.•Radiotherapy was considered when patients with disadvantageous removal factors. The optimal management of craniopharyngioma is still controversial. The aim of this study is to explore microsurgical outcomes of craniopharyngioma in 335 cases. Clinical data of 335 consecutive patients with craniopharyngioma between March 2011 and March 2017 were retrospectively analyzed. Gross total resection (GTR) was achieved in 265 cases (79.1%), subtotal resection (STR) was obtained in 70 cases (20.9%). The GTR rate was 81.93% in pediatric group and 78.17% in adult group respectively, no significant difference regarding the GTR rate was found in adult group compared with in pediatric group (p > 0.05). However, there was a noticeable difference in the elevated hypothalamic obesity in children group compared with in adult group after operation (p < 0.05). Multivariate analysis indicated that the tumor recurrence and surgical times played a negative role in the resection extent, the odds ratio and 95% confidence interval of the tumor recurrence and surgical times is [0.306 (0.155–0.603), (p < 0.01)] and [2.135 (1.101–4.142), (p < 0.05)] respectively. There was significant difference on panhypopituitarism between GTR and STR group (p < 0.05). However, No significant difference regarding the postoperative visual dysfunction and indepent quality of life respectively between GTR and STR group was found (p > 0.05). Additionally, there were no statistically significant differences for recurrence-free curves between GTR and STR plus adjuvant radiotherapy (p > 0.05). Present findings demonstrated that tumor recurrence and surgical times contribute to negative total resection for craniopharyngioma. Postoperative precise adjuvant radiotherapy was considered in selected cases if pursuit of GTR was rather dangerous under disadvantageous removal factors.

• Publisher: Elsevier B.V,Elsevier Limited
• Subject: Adjuvant radiotherapy / Adolescent / Adult / Aged / Child / Child, Preschool / Craniopharyngioma / Craniopharyngioma - mortality / Craniopharyngioma - surgery / Disease-Free Survival / Endoscopy / Ependymoma - pathology / Ependymoma - surgery / Female / Humans / Hypopituitarism - mortality / Infant / Male / Microsurgical treatment / Middle Aged / Morbidity / Mortality / Neoplasia / Neoplasm Recurrence, Local - surgery / NMR / Nuclear magnetic resonance / Pediatrics / Pituitary / Pituitary Neoplasms - surgery / Quality of Life / Radiation therapy / Surgery / Surgical outcomes / Three-dimensional printing / Young Adult