Long-Term Outcomes of Surgery and Radiation Treatment for Adult Patients with Craniopharyngioma.
Publication/Presentation Date
7-1-2024
Abstract
OBJECTIVE: Treatment of craniopharyngioma typically entails gross total resection (GTR) or subtotal resection with adjuvant radiation (STR-RT). We analyzed outcomes in adults with craniopharyngioma undergoing GTR versus STR-RT.
METHODS: This retrospective study enrolled 115 patients with craniopharyngioma in 5 institutions. Patients with STR received postoperative RT with stereotactic radiosurgery or fractionated radiation therapy per institutional preference and ability to spare optic structures.
RESULTS: Median age was 44 years (range, 19-79 years). GTR was performed in 34 patients and STR-RT was performed in 81 patients with median follow-up of 78.9 months (range, 1-268 months). For GTR, local control was 90.5% at 2 years, 87.2% at 3 years, and 71.9% at 5 years. For STR-RT, local control was 93.6% at 2 years, 90.3% at 3 years, and 88.4% at 5 years. At 5 years following resection, there was no difference in local control (P = 0.08). Differences in rates of visual deterioration or panhypopituitarism were not observed between GTR and STR-RT groups. There was no difference in local control in adamantinomatous and papillary craniopharyngioma regardless of treatment. Additionally, worse local control was found in patients receiving STR-RT who were underdosed with fractionated radiation therapy (P = 0.03) or stereotactic radiosurgery (P = 0.04).
CONCLUSIONS: Good long-term control was achieved in adults with craniopharyngioma who underwent STR-RT or GTR with no significant difference in local control. First-line treatment for craniopharyngioma should continue to be maximal safe resection followed by RT as needed to balance optimal local control with long-term morbidity.
Volume
187
First Page
852
Last Page
852
ISSN
1878-8769
Published In/Presented At
Poiset, S. J., Song, A., In Yoon, H., Huang, J., Jain, S., Palmer, J. D., Matsui, J. K., Cappelli, L., Mazza, J. M., Ali, A. S., Evans, J. J., Farrell, C. J., Kearns, K. N., Sheehan, J. P., & Shi, W. (2024). Long-Term Outcomes of Surgery and Radiation Treatment for Adult Patients with Craniopharyngioma. World neurosurgery, 187, e852–e859. https://doi.org/10.1016/j.wneu.2024.04.177
Disciplines
Medicine and Health Sciences
PubMedID
38719077
Department(s)
Department of Surgery
Document Type
Article