Craniopharyngiomas in childhood

Shapiro, Kenneth; Till, Kenneth; Grant, D N

doi:10.3171/jns.1979.50.5.0617

Cited by 127 publications

(7 citation statements)

References 6 publications

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“…We reviewed the recent literature concerning sex and ages at time of presentation [1, 3, 5, 7, 9, 10, 17,22,23,24,25,26,27,28,29,30,31]. The total number was 1,039 cases, male 558 (53.7%), female 481 (43.3%).…”

Section: Resultsmentioning

confidence: 99%

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Craniopharyngiomas in Children

2007

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Background: The modern era of pediatric craniopharyngioma treatment includes multiple modalities including microsurgical resection, irradiation, brachytherapy or chemotherapy. No clear consensus as to the best therapeutic approach has yet been established. The aim of this study was to describe the techniques and strategies for the treatment of pediatric craniopharyngiomas in light of a literature review with particular attention to the incidence of adverse postoperative effects. Methods: Twenty-seven pediatric patients (median age 9.0 years) who were surgically treated for craniopharyngiomas were evaluated. We reviewed the recent literature for clinical features of craniopharyngiomas in children, including the present cases. Results: The overall rate of radiographically complete resection of our cases was 92.6%. In the literature we reviewed, the rate of gross total resection was 33–91% (average 57.8%). According to the literature, recurrence rates range from zero to 52.8% (average 16.1%) in the gross total resection group, 51.1% in the subtotal resection without radiation therapy group, and 33.5% in the subtotal resection with radiation therapy group. In six of our most recent cases, for whom we have complete outcome analysis, radiographically complete resection is 100% with only one recurrence so far over 4 years. Conclusions: For patients in whom early postoperative MRI reveals complete craniopharyngioma removal, a very low rate of recurrence is anticipated. In the authors’ experience, radiographically total excision of even large craniopharyngiomas can be safely achieved by one or a combination of several advanced microsurgical techniques, sometimes by a staged strategy. Major morbidities can be avoided, although moderate morbidities occur and require management.

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Section: Resultsmentioning

confidence: 99%

“…In various large surgical series, several authors described the results of tumor GTR or subtotal resection (STR) with or without radiation therapy, in terms of recurrence rates (table 3) [1, 3, 5,8,9,10,22,23,24,25, 28, 29, 31, 36,44,45,46,47]. …”

Section: Discussionmentioning

confidence: 99%

Craniopharyngiomas in Children

2007

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“…Following this enthusiasm for gross total resection, the associated mortality (up to 50% at 10 years) and the high rate of recurrence despite surgical clearance (up to 50% in some series) became apparent (Shapiro et al, 1979; Carmel et al, 1982; McLone et al, 1982; Sung, 1982; Till, 1982; Pierre-Kahn et al, 1988; Fischer et al, 1990; Yasargil et al, 1990; Hoffman et al, 1992; Hetelekidis et al, 1993; Tomita and McLone, 1993; De Vile et al, 1996b; Zuccaro et al, 1996; Villani et al, 1997; Caldarelli et al, 1998; Zuccaro, 2005). …”

Section: Criticism Of the Traditional Surgical Approachmentioning

confidence: 99%

Treatment Strategies in Childhood Craniopharyngioma

Puget¹

2012

Front. Endocrin.

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The surgical management of craniopharyngiomas in children remains one of the more controversial topics in pediatric neurosurgery. Theoretically, the benign histology implies that total surgical excision would be sufficient to provide a cure. It has been widely established however, that in certain cases total excision may lead to unacceptable hypothalamic injury. The therapeutic goals for pediatric craniopharyngiomas therefore, require not just cure of the disease but also preservation of function. Over the last 15 years, there has been a growing worldwide advocacy for less extensive resection and for the utilization of multimodality therapy to limit morbidity. With this in mind, risk-adapted strategies designed to preserve hypothalamic structures have been developed. The preliminary results of these strategies appear to be encouraging. However, the long-term clinical outcome in terms of post irradiation complications and management of relapses is currently unknown.

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“…Several studies have found that partial resection and post-operative radiotherapy yield similar disease control rates to GTR with the additional benefit of decreased morbidity. [14][15][16][17][18][19][20] Puget et al 21…”

Section: Surgical Evidencementioning

confidence: 99%

Update on the Surgical Management of Craniopharyngiomas

Komotar

Kellner

Bruce

2010

European Neurological Review

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Despite advances in microsurgical and skull base techniques, the surgical treatment of craniopharyngiomas continues to pose a challenge to surgeons. Controversy continues to exist between proponents of subtotal resection in conjunction with radiotherapy, who argue that this less aggressive approach can yield equivalent control rates with lower morbidity, and others who argue for the superiority of gross total resection. Regardless of whether gross total or subtotal resection is the goal, surgical planning must include a thorough endocrine and neuroophthamological evaluation as well as imaging, and the approach, whether trans-sphenoidal or transcranial, must take into account the nature of the tumour and its location. In addition, optimal management of craniopharyngiomas must consist of individualised and multidisciplinary therapy including an array of subspeciality fields such as endocrinology, neuro-ophthalmology, neuropsychology and radiation oncology.

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Craniopharyngiomas in childhood

Cited by 127 publications

References 6 publications

Craniopharyngiomas in Children

Craniopharyngiomas in Children

Treatment Strategies in Childhood Craniopharyngioma

Update on the Surgical Management of Craniopharyngiomas

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