Craniopharyngiomas in children: how radical should the surgeon be?

Štěňo, Juraj; Bízik, I; Šteňo, Andrej; Matejčı́k, Viktor

doi:10.1007/s00381-010-1330-8

Cited by 51 publications

(32 citation statements)

References 37 publications

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“…According to Steno et al, primary supradiaphragmatic craniopharyngiomas differ from originally subdiaphragmatic, and are associated with a less favorable prognosis [25,34]. However, the suprasellar extension of a subdiaphragmatic craniopharyngioma might be still subdiaphragmatic; in this case, the diaphragm covers most of the suprasellar portion, making the tumor less adherent to neurovascular structures.…”

Section: Correlations Between Neuroimaging Characteristics and Postopmentioning

confidence: 94%

“…Steno et al [34] and Pascual et al [35] reported a higher hypothalamic complication rate, in case of tumors with intraventricular extension as compared with purely extraventricular tumors [34]. To preserve the hypothalamic function, it is very important to distinguish between suprasellar extraventricular and suprasellar intra-and extra-ventricular craniopharyngioma.…”

Section: Correlations Between Neuroimaging Characteristics and Postopmentioning

confidence: 98%

“…Particularly, the ''severe hypothalamic involvement'' is assigned to retrochiasmatic tumor with non-identifiable hypothalamus on MRI, without any difference between hypothalamic compression or infiltration and the degree of adherence of the tumor to diencephalic structures [25,34].…”

Section: Correlations Between Neuroimaging Characteristics and Postopmentioning

confidence: 99%

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Magnetic resonance imaging as predictor of functional outcome in craniopharyngiomas

et al. 2015

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Quality of life of craniopharyngioma patients can be severely impaired by derangement of hypothalamic function. A classification, taking into account preoperative hypothalamic damage, evaluated by magnetic resonance imaging (MRI), and correlating it with postoperative weight change is still missing in the literature. The aim of our study is to identify objective radiological criteria as preoperative prognostic factors for hypothalamic damage. Pre- and post-operative MRI and clinical data of 47 patients, treated at our Institution for craniopharyngioma, were retrospectively analyzed, based on radiological variables, identified as prognostic factor for hypothalamic involvement. Main factors associated with postoperative obesity were hypothalamic hyperintensity in T2-weighted/FLAIR imaging (p < 0.033), mammillary body involvement according to Müller classification (p < 0.020), unidentifiable pituitary stalk (p < 0.001), dislocated chiasm (p < 0.038), either not visible infundibular recess (p < 0.019) or unrecognizable supra-optic recess (p < 0.004), and retrochiasmatic tumor extension (p < 0.019). Accordingly, postoperative hypothalamic syndrome was associated with peritumoral edema in T2-weighted/FLAIR images (p < 0.003), unidentifiable hypothalamus (p < 0.024), hypothalamic compression (p < 0.006), fornix displacement (p < 0.032), and unrecognizable supra-optic recess (p < 0.031). Ultimately, variables identified as predictive factors of postoperative hypothalamic syndrome were the degree of hypothalamic involvement according to the classification described by Sainte-Rose and Puget (p < 0.002; grade 0 vs 2 p < 0.001), Van Gompel (p < 0.002; grade 0 vs 1, p < 0.027; and grade 0 vs 2, p < 0.002), and Muller (p < 0.006; grade 0 vs 1, p < 0.05; and grade 0 vs 2, p < 0.004). The identification of these predictive factors will help to define and score the preoperative hypothalamic involvement in craniopharyngioma patients.

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Section: Correlations Between Neuroimaging Characteristics and Postopmentioning

confidence: 94%

Section: Correlations Between Neuroimaging Characteristics and Postopmentioning

confidence: 98%

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Magnetic resonance imaging as predictor of functional outcome in craniopharyngiomas

et al. 2015

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“…Causes of late mortality include those directly related to the tumor or its treatment such as progressive disease with multiple recurrences, chronic hypothalamic insufficiency, hormonal deficiencies, cerebrovascular disease, and seizures (26,38,40,48). Other disease-related causes of mortality have been described, including decreased mineral bone density and non-alcoholic steatohepatitis, leading to liver cirrhosis in some cases (38,40).…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Hydrocephalus and hypothalamic involvement in pediatric patients with craniopharyngioma or cysts of Rathke's pouch: impact on long-term prognosis

Daubenbüchel

Hoffmann

Gebhardt

et al. 2015

European Journal of Endocrinology

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Objective: Pediatric patients with sellar masses such as craniopharyngioma (CP) or cyst of Rathke's pouch (CRP) frequently suffer disease-and treatment-related sequelae. We analyzed the impact and prognostic relevance of initial hydrocephalus (HY) and hypothalamic involvement (HI) on long-term survival and functional capacity (FC) in children with CP or CRP. Subjects and methods: Using retrospective analysis of patient records, presence of initial HY or HI was assessed in 177 pediatric patients (163 CP and 14 CRP). Twenty-year overall survival (OS) and progression-free survival (PFS), FC, and BMI were analyzed with regard to initial HY, degree of resection, or HI. Results: Of the 177 patients, 105 patients (103/163 CP and 2/14 CRP) presented with initial HY and 96 presented with HI. HY at diagnosis was associated (PZ0.000) with papilledema, neurological deficits, and higher BMI at diagnosis and during followup. OS, PFS, and FC were not affected by HY at initial diagnosis. HI at diagnosis (96/177) had major negative impact on longterm prognosis. Sellar masses with HI were associated with lower OS (0.84G0.04; PZ0.021), lower FC (PZ0.003), and higher BMI at diagnosis and last follow-up (PZ0.000) when compared with sellar masses without HI (OS: 0.94G0.05). PFS was not affected by HI or degree of resection. Conclusions: Initial HY has no impact on outcome in patients with sellar masses. OS and FC are impaired in survivors presenting with initial HI. PFS is not affected by HY, HI, or degree of resection. Accordingly, gross-total resection is not recommended in sellar masses with initial HI to prevent further hypothalamic damage.

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“…Progressive hypothalamic involvement correlated with larger postoperative weight gains. Steno et al [13] reported a higher hypothalamic complication rate, in case of tumors with intraventricular extension as compared with purely extraventricular tumors. To preserve the hypothalamic function, the authors recommend to distinguish between suprasellar extraventricular and suprasellar intra-and extraventricular craniopharyngioma.…”

Section: Grading Systems For Hypothalamic Involvement/ Lesions In Cpmentioning

confidence: 99%

Preoperative staging in childhood craniopharyngioma: standardization as a first step towards improved outcome

Müller

2015

Endocrine

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Craniopharyngiomas in children: how radical should the surgeon be?

Cited by 51 publications

References 37 publications

Magnetic resonance imaging as predictor of functional outcome in craniopharyngiomas

Magnetic resonance imaging as predictor of functional outcome in craniopharyngiomas

Hydrocephalus and hypothalamic involvement in pediatric patients with craniopharyngioma or cysts of Rathke's pouch: impact on long-term prognosis

Preoperative staging in childhood craniopharyngioma: standardization as a first step towards improved outcome

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