Tomokatsu Hori1,2, Kosaku Amano3, Takakazu Kawamata3, Motohiro Hayashi4,5, Genichiro Ohhashi6, Shinichiro Miyazaki6, Masami Ono7, Nobuhiro Miki7. 1. Moriyama Neurological Center Hospital, Tokyo, Japan. thori@moriyamaikai.or.jp. 2. Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan. thori@moriyamaikai.or.jp. 3. Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan. 4. Faculty of Advanced Techno-Surgery and Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan. 5. Saitama Gamma Knife Center, Sanai Hospital, Saitama, Japan. 6. Department of Neurosurgery, Shin-Yurigaoka General Hospital, Kawasaki, Kanagawa, Japan. 7. Department of Endocrinology, Tokyo Neurological Center Hospital, Tokyo, Japan.
Abstract
OBJECTIVE: Experience with management of craniopharyngiomas (CPH) was evaluated retrospectively. METHODS: Between 1981 and 2012, 100 patients underwent removal of a CPH (the main surgical group), and an original tumor grading system was applied to these cases. The mean length of follow-up was 121 months. Additionally, 17 patients underwent removal of a CPH between 2012 and 2017 (the supplementary surgical group), and in 6 of them, CyberKnife radiosurgery was performed on a residual tumor (in 5 cases) or at the time of recurrence (in 1 case). RESULTS: In the main surgical group, the gross total resection (GTR) rate was 81%. The early and late disease-specific postoperative mortality rates were 0% and 2%, respectively. Tumor recurrence was never noted after GTR. There was a statistically significant increase in the Karnofsky Performance Scale (KPS) score after surgery. The tumor surgical grade was inversely associated with both the pre- and postoperative KPS scores, and was lower in cases operated on via the transnasal transsphenoidal approach, but was unrelated to the GTR rate. In the supplementary surgical group, the GTR rate was 65%. CyberKnife radiosurgery consistently resulted in tumor shrinkage. CONCLUSION: GTR is the preferred management option for CPH. The original surgical grading system developed at Tokyo Women's Medical University may be helpful for clinical decision-making. CyberKnife radiosurgery for residual and recurrent CPH is associated with high tumor response rates.
OBJECTIVE: Experience with management of craniopharyngiomas (CPH) was evaluated retrospectively. METHODS: Between 1981 and 2012, 100 patients underwent removal of a CPH (the main surgical group), and an original tumor grading system was applied to these cases. The mean length of follow-up was 121 months. Additionally, 17 patients underwent removal of a CPH between 2012 and 2017 (the supplementary surgical group), and in 6 of them, CyberKnife radiosurgery was performed on a residual tumor (in 5 cases) or at the time of recurrence (in 1 case). RESULTS: In the main surgical group, the gross total resection (GTR) rate was 81%. The early and late disease-specific postoperative mortality rates were 0% and 2%, respectively. Tumor recurrence was never noted after GTR. There was a statistically significant increase in the Karnofsky Performance Scale (KPS) score after surgery. The tumor surgical grade was inversely associated with both the pre- and postoperative KPS scores, and was lower in cases operated on via the transnasal transsphenoidal approach, but was unrelated to the GTR rate. In the supplementary surgical group, the GTR rate was 65%. CyberKnife radiosurgery consistently resulted in tumor shrinkage. CONCLUSION:GTR is the preferred management option for CPH. The original surgical grading system developed at Tokyo Women's Medical University may be helpful for clinical decision-making. CyberKnife radiosurgery for residual and recurrent CPH is associated with high tumor response rates.
Authors: S Hetelekidis; P D Barnes; M L Tao; E G Fischer; L Schneider; R M Scott; N J Tarbell Journal: Int J Radiat Oncol Biol Phys Date: 1993-09-30 Impact factor: 7.038
Authors: Amin B Kassam; Paul A Gardner; Carl H Snyderman; Ricardo L Carrau; Arlan H Mintz; Daniel M Prevedello Journal: J Neurosurg Date: 2008-04 Impact factor: 5.115