Surgery with or without radiation therapy in the management of craniopharyngiomas in children and young adults

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

“…It is not clear whether the presence of HY constitutes a prognostic factor because both increased mortality (12) and lack of association with mortality have been reported (13,14,15,16). Our retrospective analyses of the thus far largest published cohort of long-term survivors of childhood-onset CP and CRP show that HY at diagnosis was not associated with reduced survival rates and impaired FC during long-term follow-up, supporting previous reports (13,14,15,16).…”

“…The OS rates (which reflect effect of multiple treatments) described in an exclusively pediatric series ranged from 83 to 96% at 5 years (14, 15, 17, 30, 31, 32, 33) and 65 to 100% at 10 years (15, 26, 30, 31, 32, 34, 35, 36, 37, 38, 39, 40, 41), averaging 62% at 20 years (42). In adults or a broad age-range population (adults and children) series, the OS rates ranged from 54 to 96% at 5 years (13,16,25,29,32,43,44,45,46), 40 to 93% at 10 years (13,16,25,28,29,32,43,44,45,46), and 66 to 85% at 20 years (29,45,46). The lower limits of survival rates usually reflected data from earlier series that occurred before modern advances in microsurgery, neuroimaging, and radiotherapy.…”

“…What remains unclear is whether the age at diagnosis represents a survival prognostic factor because some studies have demonstrated that the youngest patients have better survival rates (28,32,44), others have found better outcome in older patients (12,46), whereas still other studies report no difference between pediatric and adult populations (13,16,45,47). The role of sex as a prognostic factor is not established; some authors report a higher mortality among females (28,29), but others have not found any sex differences (13,15,16).…”

“…The role of sex as a prognostic factor is not established; some authors report a higher mortality among females (28,29), but others have not found any sex differences (13,15,16). One of the two studies reporting higher mortality rates in females suggested a possible role of estrogen deficiency (29), but the other study did not consider that unsupplemented gonadal insufficiency had a significant impact on enhanced mortality (28).…”

“…Based on reports in the literature (12,13,14,15,16), it is not clear whether the presence of hydrocephalus (HY) constitutes a prognostic factor for long-term outcome in pediatric patients with sellar masses. The present retrospective study assessed the impact of HY, degree of resection, and tumor location at the time of diagnosis on survival and outcome in a large cohort of long-term survivors of these sellar masses.…”