Complications in paediatric craniopharyngioma treatment

Zúccaro, Graciela; Jaimovich, Roberto; Mantese, Beatriz; Monges, J

doi:10.1007/bf00395090

Cited by 33 publications

(20 citation statements)

References 7 publications

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“…Postoperative morbidities include polyendocrinopathy and neurological dysfunction, including shunt dependence, seizures, and headaches. 13,21,101,106 Endocrine disorders, including panhypopituitarism, associated with aggressive tumor resection was considered "inevitable" and "acceptable." 76 Irreversible central diabetes insipidus and growth hormone deficiency after attempted GTR results in lifelong replacement therapy.…”

Section: Discussionmentioning

confidence: 99%

Comparative effectiveness of treatment options for pediatric craniopharyngiomas

Ali

Bailey

Daniels

et al. 2014

PED

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Object No clear treatment guidelines for pediatric craniopharyngiomas exist. The authors developed a decision analytical model to evaluate outcomes of 4 surgical approaches for craniopharyngiomas in children, including attempted gross-total resection (GTR), planned subtotal removal plus radiotherapy, biopsy plus radiotherapy, and endoscopic resections of all kinds. Methods Pooled data, including the authors' own experience, were used to create evidence tables, from which incidence, relative risks, and summary outcomes in quality-adjusted life years (QALYs) were calculated for the 4 management strategies. Results Quality-adjusted life years at the 5-year follow-up were 2.3 ± 0.1 for attempted GTR, 2.9 ± 0.2 for planned subtotal removal plus radiotherapy, 3.9 ± 0.2 for biopsy plus radiotherapy, and 3.7 ± 0.2 for endoscopic resection (F = 17,150, p < 0.001). Similarly, QALYs at 10-year follow-up were 4.5 ± 0.2 for attempted GTR, 5.7 ± 0.5 for planned subtotal removal plus radiotherapy, and 7.8 ± 0.5 for biopsy plus radiotherapy (F = 6,173, p < 0.001). On post hoc pairwise comparisons, the differences between all pairs compared were also highly significant (p < 0.001). Since follow-up data at 10 years are lacking for endoscopic cases, this category was excluded from 10-year comparisons. Conclusions Biopsy with subsequent radiotherapy is the preferred approach with respect to improved overall quality of life. While endoscopic approaches also show promise in preserving quality of life at five-year follow-up, there are not sufficient data to draw conclusions about this comparison at 10 years.

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Section: Discussionmentioning

confidence: 99%

Comparative effectiveness of treatment options for pediatric craniopharyngiomas

Ali

Bailey

Daniels

et al. 2014

PED

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“…Our searches yielded 274 studies [275][276][277][279][280][281][282] reporting data for 8058 nonduplicated patients with craniophayngiomas, the majority of whom were presented in aggregated data sets. Disaggregated data useable for survival and progression analysis was presented for 800 patients.…”

Section: Data Extractionmentioning

confidence: 99%

Craniopharyngioma: a comparison of tumor control with various treatment strategies

Yang

Sughrue

Rutkowski

et al. 2010

FOC

180

113

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Object Craniopharyngiomas have a propensity to recur after resection, potentially causing death through their aggressive local behavior in their critical site of origin. Recent data suggest that subtotal resection (STR) followed by adjuvant radiotherapy (XRT) may be an appealing substitute for gross-total resection (GTR), providing similar rates of tumor control without the morbidity associated with aggressive resection. Here, the authors summarize the published literature regarding rates of tumor control with various treatment modalities for craniopharyngiomas. Methods The authors performed a comprehensive search of the English language literature to identify studies publishing outcome data on patients undergoing surgery for craniopharyngioma. Rates of progression-free survival (PFS) and overall survival (OS) were determined through Kaplan-Meier analysis. Results There were 442 patients who underwent tumor resection. Among these patients, GTR was achieved in 256 cases (58%), STR in 101 cases (23%), and STR+XRT in 85 cases (19%). The 2- and 5-year PFS rates for the GTR group versus the STR+XRT group were 88 versus 91%, and 67 versus 69%, respectively. The 5- and 10-year OS rates for the GTR group versus the STR+XRT group were 98 versus 99%, and 98 versus 95%, respectively. There was no significant difference in PFS (log-rank test) or OS with GTR (log-rank test). Conclusions Given the relative rarity of craniopharyngioma, this study provides estimates of outcome for a variety of treatment combinations, as not all treatments are an option for all patients with these tumors.

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“…Neurological problems are more likely to occur if the hyponatremia develops acutely [9]. In one report of vascular complications in surgery for craniopharyngioma, it was assumed that the massive cerebral infarction which led in one case to fatal outcome 6 days after surgery was due to an interruption of the vascular supply from the external carotid artery in the course of the pterional flip incision, together with the vasospasm arising from surgical trauma or from hyperventilation [20]. …”

Section: Discussionmentioning

confidence: 99%

Radical Surgery in a Neonate with Craniopharyngioma

Müller-Scholden¹,

Lehrnbecher²,

Müller³

et al. 2000

Pediatr Neurosurg

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Ultrasonography revealed a suprasellar tumor in a fetus at 28 weeks of gestation. The male newborn, delivered 10 weeks later, was operated at the age of 17 days, and a craniopharyngioma was completely removed. Intraoperatively, inappropriate secretion of antidiuretic hormone occurred and was followed by diabetes insipidus causing imbalance of fluid and electrolytes. The tumor recurred and was totally removed 1 year later. Further development was uneventful and, at the age of 8 years, the boy is in generally good mental and physical condition except for a left-sided hemiparesis. In contrast to the poor outcome of neonatal craniopharyngioma reviewed in the literature, this case may encourage radical surgery even in the very young.

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Complications in paediatric craniopharyngioma treatment

Cited by 33 publications

References 7 publications

Comparative effectiveness of treatment options for pediatric craniopharyngiomas

Comparative effectiveness of treatment options for pediatric craniopharyngiomas

Craniopharyngioma: a comparison of tumor control with various treatment strategies

Radical Surgery in a Neonate with Craniopharyngioma

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