BACKGROUND: Medium- and long-term prognosis of craniopharyngioma is overwhelmed by the risks of hypothalamic and visual impairment. This problem has been underestimated for a long time because the major concern for the neurosurgeon was the risk of recurrences, their best prevention being thought to be complete tumour resection. Today, we know that radical surgery not only is not an absolute guarantee against recurrences but also can cause hypothalamic and visual complications. METHODS: The authors suggest that instead of complete removal, the first choice treatment should be, when possible, a less aggressive, multistaged and personalized treatment. In this perspective they focus on other therapeutic methods: endocavity treatment of cysts with rhenium-186, triconformational radiotherapy, radiosurgery, and widespread use of the trans-sphenoidal approach. CONCLUSIONS: These simple methods should reduce the risks of visual aggravation and metabolic syndrome.
BACKGROUND: Medium- and long-term prognosis of craniopharyngioma is overwhelmed by the risks of hypothalamic and visual impairment. This problem has been underestimated for a long time because the major concern for the neurosurgeon was the risk of recurrences, their best prevention being thought to be complete tumour resection. Today, we know that radical surgery not only is not an absolute guarantee against recurrences but also can cause hypothalamic and visual complications. METHODS: The authors suggest that instead of complete removal, the first choice treatment should be, when possible, a less aggressive, multistaged and personalized treatment. In this perspective they focus on other therapeutic methods: endocavity treatment of cysts with rhenium-186, triconformational radiotherapy, radiosurgery, and widespread use of the trans-sphenoidal approach. CONCLUSIONS: These simple methods should reduce the risks of visual aggravation and metabolic syndrome.
Authors: Robert H Lustig; Susan R Post; Kleebsabai Srivannaboon; Susan R Rose; Robert K Danish; George A Burghen; Xiaoping Xiong; Shengjie Wu; Thomas E Merchant Journal: J Clin Endocrinol Metab Date: 2003-02 Impact factor: 5.958
Authors: Andrea Poretti; Michael A Grotzer; Karin Ribi; Eugen Schönle; Eugen Boltshauser Journal: Dev Med Child Neurol Date: 2004-04 Impact factor: 5.449
Authors: Philipp Kickingereder; Mohammad Maarouf; Faycal El Majdoub; Manuel Fuetsch; Ralph Lehrke; Jochen Wirths; Klaus Luyken; Klaus Schomaecker; Harald Treuer; Juergen Voges; Volker Sturm Journal: J Neurooncol Date: 2012-06-21 Impact factor: 4.130
Authors: Todd C Hankinson; Emma C Fields; Michelle R Torok; Brenda L Beaty; Michael H Handler; Nicholas K Foreman; Brent R O'neill; Arthur K Liu Journal: J Neurooncol Date: 2012-08-23 Impact factor: 4.130
Authors: Mohammad Maarouf; Faycal El Majdoub; Manuel Fuetsch; Mauritius Hoevels; Ralph Lehrke; Frank Berthold; Jürgen Voges; Volker Sturm Journal: Strahlenther Onkol Date: 2015-11-05 Impact factor: 3.621