Yun Bao1, Binghui Qiu1, Songtao Qi2, Jun Pan1, Yuntao Lu1, Junxiang Peng1. 1. Department of Neurosurgery, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China. 2. Department of Neurosurgery, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China. bobkuanci@hotmail.com.
Abstract
PURPOSE: Craniopharyngioma is a common pediatric brain tumor, with a high rate of recurrence after primary treatment. This retrospective study investigated the effect of various primary treatments on surgical strategies and outcomes for recurrent craniopharyngiomas. METHODS: The study population comprised 35 children (mean age 8.77 years, range 1-16 years) with recurrent craniopharyngioma re-operated from January 1990 to January 2009. The recurrent craniopharyngiomas were excised whenever possible. For analysis, the patients were divided into four groups according to the primary treatment: radical tumor resection (A), incomplete tumor resection (B), radiotherapy + incomplete tumor resection (C), and Ommaya reservoir placement + incomplete tumor resection (D). RESULTS: Group B had a significantly shorter recurrence-free interval than groups A, C, or D. Outcomes were significantly different among the four groups. The hypothalamic status scores of groups A (2.38 ± 0.27) and C (2.28 ± 0.42) were significantly higher than that of group B (1.64 ± 0.20). There were no statistical differences between any two other groups. CONCLUSIONS: In children, the primary treatments for craniopharyngioma should be considered when choosing the surgical strategy for recurrence. Radiotherapy before repeated surgery can result in a worse functional outcome and hypothalamic-pituitary function.
PURPOSE:Craniopharyngioma is a common pediatric brain tumor, with a high rate of recurrence after primary treatment. This retrospective study investigated the effect of various primary treatments on surgical strategies and outcomes for recurrent craniopharyngiomas. METHODS: The study population comprised 35 children (mean age 8.77 years, range 1-16 years) with recurrent craniopharyngioma re-operated from January 1990 to January 2009. The recurrent craniopharyngiomas were excised whenever possible. For analysis, the patients were divided into four groups according to the primary treatment: radical tumor resection (A), incomplete tumor resection (B), radiotherapy + incomplete tumor resection (C), and Ommaya reservoir placement + incomplete tumor resection (D). RESULTS: Group B had a significantly shorter recurrence-free interval than groups A, C, or D. Outcomes were significantly different among the four groups. The hypothalamic status scores of groups A (2.38 ± 0.27) and C (2.28 ± 0.42) were significantly higher than that of group B (1.64 ± 0.20). There were no statistical differences between any two other groups. CONCLUSIONS: In children, the primary treatments for craniopharyngioma should be considered when choosing the surgical strategy for recurrence. Radiotherapy before repeated surgery can result in a worse functional outcome and hypothalamic-pituitary function.
Authors: R M Villani; G Tomei; L Bello; E Sganzerla; B Ambrosi; T Re; M Giovanelli Barilari Journal: Childs Nerv Syst Date: 1997-07 Impact factor: 1.475
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