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

The development of hypothalamic obesity in craniopharyngioma patients: A risk factor analysis in a well‐defined cohort

“…However, because of a low interobserver agreement for preoperative hypothalamic involvement between two well‐experienced neuroradiologists, we instead used obesity at diagnosis as surrogate marker of possible preoperative hypothalamic involvement. For future studies, alternative MRI criteria to define hypothalamic involvement, such as tumor extension toward the mammillary bodies, should be considered, and the interobserver variability of scoring systems deserves further attention …”

“…For this reason, we evaluated the influence of preoperative hypothalamic involvement and the extent of surgical resection on the development of HO. Of the different tools developed to assess hypothalamic involvement, the Paris grading is a widely used scoring system . Therefore, we also intended to use the Paris grading in our cohort to define the existence of preoperative hypothalamic involvement.…”

Neurocognitive functioning in pediatric craniopharyngioma: performance before treatment with proton therapy

“…Though craniopharyngioma is rare, between 30% and 50% are diagnosed during childhood with peak onset between 5 and 14 years of age [1,2]. Despite its benign histopathology, craniopharyngioma often results in endocrinopathies and visual disturbance secondary to the impact of tumor on the hypothalamus/pituitary axis and optic pathways, respectively [1–3]. …”

“…Contemporary research suggests craniopharyngioma should be managed initially using surgery with the goal of relieving increased intracranial pressure, improving visual dysfunction, and reducing target volume for radiation therapy [3]. Given the association between pre- and postoperative hypothalamic involvement (HI) and greater morbidity, utilization of HI grading systems prior to surgical intervention and hypothalamus-sparing surgical approaches are being used.…”

“…Given the association between pre- and postoperative hypothalamic involvement (HI) and greater morbidity, utilization of HI grading systems prior to surgical intervention and hypothalamus-sparing surgical approaches are being used. Treatment with radiation therapy following surgical resection has been recommended in contemporary studies, which have revealed comparable 5- and 10-year progression-free survival rates whether patients were treated with radical resection versus partial resection combined with radiation therapy [3]. A number of studies have recommended treatment with proton therapy (PT) given its potential to spare healthy brain tissue and improve functional and quality of life outcomes [1,3].…”