Long-term results of the surgical treatment of craniopharyngioma: the experience at the Policlinico Gemelli, Catholic University, Rome

Caldarelli, Massimo; Massimi, L; Tamburrini, Gianpiero; Cappa, Marco; Rocco, C. Di

doi:10.1007/s00381-005-1186-5

Cited by 178 publications

(179 citation statements)

References 41 publications

Supporting

Mentioning

161

Contrasting

Unclassified

Order By: Relevance

“…Earlier studies in COCP patients have reported that pituitary hormone deficits occur in 40-87% of the cases (23). In this study, pituitary hormone deficits were more prevalent in COCP patients than in COH or COE patients, which may either be induced or be worsened by surgery and/or radiotherapy to the hypothalamicpituitary region (21,24).…”

Section: Discussionmentioning

confidence: 46%

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Yuen

Kołtowska-Häggström

Cook³

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Adults with childhood-onset (CO) craniopharyngioma (COCP) have poor quality of life (QoL) and clinical outcomes, but few studies have compared these patients with adults with other causes of CO hypothalamic-pituitary dysfunction. In this study, we compared baseline clinical characteristics and patient-reported outcomes before starting GH replacement therapy in adults with GH deficiency (GHD) due to COCP with those of adults either with CO idiopathic/congenital hypopituitarism (COH) or with CO extrasellar (COE) tumours, and evaluated the 1-and 5-year effects of GH replacement therapy. Subjects and methods: Retrospective analysis of the data recorded in KIMS (Pfizer International Metabolic Database) was carried out. Patients with COCP, COH and COE tumours were evaluated at baseline, and after 1 and 5 years of therapy. Results: Compared with COH and COE patients, more COCP patients underwent surgery, had greater abnormalities of body composition and higher prevalence of pituitary hormone deficits (all P!0.001), but comparable fasting glucose, HbA1c, total cholesterol and LDL-cholesterol levels, marital status, parenthood, living arrangements, education, employment and annual sick-leave days. After 1 and 5 years of GH replacement therapy, similar changes were evident with regard to body composition, fasting glucose and HbA1c levels, QoL, and the level of and satisfaction with physical activity across the three groups. Conclusions: Adults with untreated COCP with GHD at baseline demonstrated more co-morbidities including greater abnormalities of body composition, pituitary hormone deficits and visual field defects. Overall, adults with COCP, COH and COE tumours responded comparably to short-and long-term GH replacement therapy, suggesting that patients with GHD due to COCP benefited from GH replacement therapy to a similar degree as those with other causes of CO hypothalamic-pituitary dysfunction did.

show abstract

Section: Discussionmentioning

confidence: 46%

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Yuen

Kołtowska-Häggström

Cook³

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…Indeed, childhood craniopharyngiomas are larger and more difficult to remove completely 7 . In children, cysts are present in 90% of all craniopharyngiomas.…”

Section: Discussionmentioning

confidence: 99%

“…The adamantinomatous variant is prevalent, whereas the papillary or mixed type is rare. Even after complete surgical removal, the incidence of recurrence is also high among children 3,7,8 . The retrochiasmatic variant, which is associated to significant impairment of the hypothalamus, accounts for approximately 50% of cases, whereas the purely intrasellar type is rare.…”

Section: Discussionmentioning

confidence: 99%

“…Thirty percent of patients exhibit associated obstructive hydrocephalia. The reason for this complex behavior in childhood has not yet been fully clarified, but the early clinical manifestation of a tumor known to be of a congenital nature is believed to be related to more aggressive biological behavior 3,7 . According to reports from pediatric series and studies on mixed populations of patients, the lower rate of complete resections in children in comparison to adults demonstrates that technical difficulties are truly greater in the child population.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cystic craniopharyngioma: intratumoral chemotherapy with alpha interferon

Dastoli

Nicácio

Silva

et al. 2011

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Objective: To assess whether the cystic craniopharyngiomas can be controlled with the use of intratumoral applications of interferon alpha. Method: Nineteen patients with the diagnosis of cystic craniopharyngioma were treated with intratumoral chemotherapy with interferon alpha from January 2002 to April 2006. All patients underwent placement of an intracystic catheter connected to an Ommaya reservoir. Through this reservoir were made applications during chemotherapy cycles. Each cycle corresponded to application of 3,000,000 units of interferon alpha three times per week on alternate days totalizing 36,000,000 units. Response to treatment was evaluated by calculating the tumor volume on MRI control after one, three and six months after the end of each cycle. Patients who developed worsening of symptoms or who had insignificant reduction in tumor volume during follow-up underwent repeat cycle chemotherapy. Results: Four patients received four cycles of chemotherapy, three patients received three cycles, six patients received two cycles and six patients received one. The lower percentage of reduction in tumor volume was 60% and the bigger reduction was 98.37%. Eleven patients had a reduction greater than 90%. Five patients had a tumor reduction between 75 and 90% and in three patients the tumors were reduced by less than 75%. No deaths occurred during treatment and side effects of interferon alpha were well tolerated. No treatment was discontinued. Follow-up after the last application ranged from one year and five months to three years and nine months. Conclusion: The intratumoral chemotherapy with interferon alpha decreases the volume of cystic craniopharyngiomas and so far can be considered a new therapeutic alternative.

show abstract

“…They show low-grade histological malignancy (WHO 8I) and frequently affect hypothalamic and pituitary regions due to their location. Hypothalamic involvement (HI) of CP, resulting in pathological patterns of eating behavior and obesity, is the most serious risk factor -its aforementioned manifestations impairing prognosis and quality of life in surviving patients (1,3,4,5,6,7,8,9,10,11,12,13,14,15). suspicion of childhood CP in the differential diagnosis process (5).…”

Section: Introductionmentioning

confidence: 99%

History before diagnosis in childhood craniopharyngioma: associations with initial presentation and long-term prognosis

Hoffmann

Boekhoff

Gebhardt

et al. 2015

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Childhood craniopharyngiomas (CP) are often diagnosed after a long duration of history (DOH). Tumor size, hypothalamic involvement (HI), and obesity are associated with reduced overall survival (OS) and functional capacity (FC). The effect of DOH and specific symptoms in history on presentation at initial diagnosis and long-term prognosis are unknown. Design: Retrospective analysis of patients' records and prospective longitudinal follow-up. Methods: Histories of 411 CP patients recruited in HIT Endo, KRANIOPHARYNGEOM 2000 were retrospectively evaluated for DOH, symptoms, and characteristics. The effect of specific manifestations and DOH on clinical presentation and tumor characteristics at time of initial CP diagnosis and long-term outcome were analyzed. Main outcome measures were 10-year OS and progression-free survival (PFS), FC, and BMI during longitudinal follow-up. Results: Median DOH was 6 months (range: 0.1-108 months) and correlated with age at diagnosis. Tumor size, HI, degree of resection, and BMI at diagnosis were not related to DOH. In multivariate analysis adjusted for age at diagnosis, only hydrocephalus was found to have a relevant influence on DOH. Visual and neurological deficits were associated with larger initial tumor size and impaired 10-year OS. Weight gain and growth failure were observed with longest DOH. PFS and FC were not related to any specific symptom. Endocrine deficits at diagnosis were associated with long DOH. Conclusions: CP is frequently diagnosed after long DOH, especially in older children. However, DOH was not associated with tumor size, HI, survival, or FC. Visual and neurological deficits necessitate rapid diagnostic workup.

show abstract

Long-term results of the surgical treatment of craniopharyngioma: the experience at the Policlinico Gemelli, Catholic University, Rome

Cited by 178 publications

References 41 publications

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Clinical characteristics and effects of GH replacement therapy in adults with childhood-onset craniopharyngioma compared with those in adults with other causes of childhood-onset hypothalamic–pituitary dysfunction

Cystic craniopharyngioma: intratumoral chemotherapy with alpha interferon

History before diagnosis in childhood craniopharyngioma: associations with initial presentation and long-term prognosis

Contact Info

Product

Resources

About