Prognostic Factors and Treatment Impact on Overall Survival in Adult Craniopharyngioma

Awad, Matthew; Butterfield, John T.; Dhawan, Sanjay; Tyler, Matthew A.; Venteicher, Andrew S.

doi:10.1016/j.wneu.2023.02.020

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…Though it may not always be the case, academic centers are likely to encounter a higher volume of craniopharyngioma cases due to the complexity of their treatment, which typically includes surgical resection with the addition of chemotherapy and/or radiation. 7,23,24 This is due in part to the invasive nature of the tumor with involvement of nearby critical neurovascular and neuroendocrine structures. Surgical and adjuvant treatment planning is paramount for successful control of craniopharyngioma requiring collaboration by an expert multidisciplinary team and resources to treat these complex skull base lesions.…”

Section: Discussionmentioning

confidence: 99%

“…33 Recently, gross total resection (GTR) and subtotal resection with adjuvant radiation have been shown to improve OS. 24 It has been shown previously in cases of head and neck malignancy that patients at HVC and academic facilities receive more aggressive treatment, and are also more likely to be treated according to evidencebased treatment guidelines. 14,22,34 This study found that those at HVC were more likely to have received radiotherapy in addition to surgery; HVC were shown to encounter tumors of larger size, which makes total resection more di cult and may have contributed to this increased use of adjunct radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

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The impact of facility type and volume on treatment and overall survival in craniopharyngioma

Bitner,

Liu,

Nottoli

et al. 2023

Pituitary

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BackgroundCraniopharyngiomas are uncommon benign sellar and parasellar tumors with high overall survival (OS) and recurrence rates. Treatment is often surgical but may include adjuvant therapies. The impact of adjuvant therapy and surgical approach have been evaluated, however, facility volume and type have not. The purpose of this study is to analyze the in uence of facility volume and type on treatment modalities, extent of surgery and survival of craniopharyngioma. MethodsThe 2004-2016 National Cancer Database (NCDB) was queried for patients diagnosed with craniopharyngioma. Facilities were classi ed by type (academic vs. non-academic) and low-(LVC, treating < 8 patients over the timeline) versus high-volume (HVC, treating ≥ 8 patients over the timeline).Differences in treatment course, outcomes, and OS by facility type were assessed. Results3730 patients (51.3% female) with mean age 41.2 ± 22.0 were included with a 5-year estimated OS of 94.8% (94.0-95.5%). 2564 (68.7%) patients were treated at HVC, of which 2142 (83.5%) were treated at academic facilities. Patients treated at HVC's were more likely to undergo both surgery and radiation. Surgical approach at HVC was more likely to be endoscopic. Patients treated at HVC demonstrated signi cantly higher 5-year OS compared to patients treated at LVC (96% [95% CI: 95.6-97.1% versus 91.2% [95% CI: 89-92.7%] with lower risk of mortality (Hazard ratio [95% CI] = 0.69 [0.56-0.84]). ConclusionTreatment of craniopharyngioma at HVC compared to LVC is associated with improved OS, lower 30-and 90-day postoperative mortality risk, and more common use of both radiotherapy and endoscopic surgical approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impact of facility type and volume on treatment and overall survival in craniopharyngioma

Bitner,

Liu,

Nottoli

et al. 2023

Pituitary

View full text Add to dashboard Cite

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Radiotherapy for rare primary brain tumors

Mesny

Lesueur

2023

Cancer/Radiothérapie

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Papillary Craniopharyngioma: An Integrative and Comprehensive Review

Prieto,

Juratli,

Bander

et al. 2024

Endocrine Reviews

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Papillary craniopharyngioma (PCP) is a rare type of tumor, comprising ∼20% of all craniopharyngioma (CP) cases. It is now recognized as a separate pathological entity from the adamantinomatous type. PCPs are benign tumors, classified as WHO grade 1, characterized by non-keratinizing squamous epithelium. They typically grow as solid and round papillomatous masses or as unilocular cysts with a cauliflower-like excrescence. PCPs primarily occur in adults (95%), with increased frequency in males (60%) and predominantly affect the hypothalamus. Over 80% of these tumors are located in the third ventricle, expanding either above an anatomically intact infundibulum (strictly third ventricle tumors) or within the infundibulo-tuberal region of the third ventricle floor. Clinical manifestations commonly include visual deficits and a wide range of psychiatric disturbances (45% of patients), such as memory deficits and odd behavior. MRI can identify up to 50% of PCPs by the presence of a basal duct-like recess. Surgical management is challenging, requiring complex approaches to the third ventricle and posing significant risk of hypothalamic injury. The endoscopic endonasal approach allows radical tumor resection and yields more favorable patient outcomes. Of intriguing pathogenesis, over 90% of PCPs harbor the somatic BRAFV600E mutation, which activates the mitogen-activated protein kinase (MAPK/ERK) signaling pathway. A phase 2 clinical trial has demonstrated that PCPs respond well to BRAF/MEK inhibitors. This comprehensive review synthesizes information from a cohort of 560 well-described PCPs and 99 large CP series including PCP cases published from 1856-2023 and represents the most extensive collection of knowledge on PCPs to date.

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Prognostic Factors and Treatment Impact on Overall Survival in Adult Craniopharyngioma

Cited by 4 publications

References 24 publications

The impact of facility type and volume on treatment and overall survival in craniopharyngioma

The impact of facility type and volume on treatment and overall survival in craniopharyngioma

Radiotherapy for rare primary brain tumors

Papillary Craniopharyngioma: An Integrative and Comprehensive Review

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