Treatment Outcomes of Pediatric Craniopharyngioma: A 5-Year Retrospective Review of 70 Cases
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- Category: Vol. 81, September 2013
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Treatment Outcomes of Pediatric Craniopharyngioma: A 5-Year Retrospective Review of 70 Cases, MOHAMED R. NAGY
Abstract
Objective: The aim of this study is to describe two centers' experience in the management of craniopharyngiomas in children over a 5-year period.
Methods: The clinical records of pediatric patients treated for craniopharyngiomas in Abu El-Rish Children Hospital and Kasr El-Aini Hospital between October 2007 and Decem-ber 2012 were reviewed. Seventy pediatric patients diagnosed with craniopharyngioma were treated, and their medical records and imaging data were analyzed retrospectively.
Results: The mean follow-up duration was 29 months (range, 5-61). Overall survival and local control rates at 3 years were 94.7±5.1% and 37.1±11.9%, respectively. The female-to-male ratio was 16:19, and the mean age was 8.6 years (range, 1-17). Initially, gross total resection (GTR) was performed in 45 patients; subtotal resection (STR) followed by radiotherapy was performed in 25 patients. Of the 22 cases that showed recurrence after GTR, 6 patients were treated with GTR, 3 with radiation therapy (RT), 4 with gamma knife radiosurgery (GKRS), and 9 with subtotal resection followed by RT. No patients who underwent RT or GKRS had recur-rences. Nine cases with recurrence after STR followed by RT were treated with STR. Two patients died of hormonal insuf-ficiency 23 and 35 months after the first surgery, respectively. The overall median time progression was 17.4 months (range, 3-62): 16.1 months in the patients who underwent GTR and 20.6 months in the patients who underwent STR followed by RT.
Conclusion: If safe resection is possible, GTR at the initial treatment should be attempted to reduce the tumor recurrence. However, if the tumor recurs after the first surgery, RT or GKRS with/without reoperation may be an effective salvage treatment for recurrent craniopharyngioma.