Craniopharyngioma in children

Khafaga, Yasser; Jenkin, Derek; Kanaan, Imad; Hassounah, Maher; Shabanah, Mohammed Al; Gray, Alan

doi:10.1016/s0360-3016(98)00257-0

Cited by 61 publications

(26 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the treatment of pediatric craniopharyngiomas, recent large surgical series have shown that the rate of total removal could reach 90%, and the operative mortality rate was generally between 0 and 4% [1,2,3,4,5,6,7,8]. The major controversy revolves around the intention to treat approach in pediatric craniopharyngioma whether by radical resection or by conservative treatment followed by radiation therapy.…”

Section: Introductionmentioning

confidence: 99%

Radical Resection of 202 Pediatric Craniopharyngiomas with Special Reference to the Surgical Approaches and Hypothalamic Protection

Zhang

et al. 2008

Pediatr Neurosurg

View full text Add to dashboard Cite

Objective: The goal of this study was to disclose the appropriate surgical approaches to radically removing pediatric craniopharyngiomas with optimal hypothalamic protection. Methods: In 202 patients undergoing primary surgery from April 1997 to December 2002, eight approaches were used to remove craniopharyngiomas in the sellar region and the third ventricle. Among the eight approaches, the transcallosal-interseptal-interforniceal approach was used in 89 cases, the unilateral transfrontal interhemispheric approach in 68 cases, the pterional approach in 20 cases, and the other five approaches in 25 cases. Active preventive and therapeutic measurements of hypothalamic dysfunction were adopted pre- and postoperatively. Results: Of the 202 cases, 184 tumors were totally or nearly totally removed (91.1%); 89 cases were resected with the transcallosal-interseptal-interforniceal approach with a total and subtotal removal rate of 92.1%, and 68 cases were removed with the unilateral transfrontal interhemispheric approach with a total and subtotal removal rate of 95.6%. Two patients died (0.9%). The major postoperative complications included diabetes insipidus in 81.7% of the cases, permanent diabetes insipidus in 11.4%, electrolyte disorder in 74.8%, and seizures in 9.4%. The 5-year survival rate was 68.2%. Conclusions: Appropriate approaches with direct tumor exposure should be determined in order to remove the craniopharyngioma as much as possible, while at the same time carefully protecting the anteroinferolateral wall of the third ventricle (hypothalamus). Active measurements to manage blood sodium disorder and seizures could help to ensure the safety of the operation.

show abstract

Section: Introductionmentioning

confidence: 99%

Radical Resection of 202 Pediatric Craniopharyngiomas with Special Reference to the Surgical Approaches and Hypothalamic Protection

Zhang

et al. 2008

Pediatr Neurosurg

View full text Add to dashboard Cite

show abstract

“…However, the morbidity of such surgery can be substantial and many patients develop recurrent tumor. Conversely, some authors recommend less aggressive surgery to establish a histologic diagnosis and decompress the adjacent neurovascular structures [6][7][8][9]. Patients then undergo fractionated radiation therapy to minimize the chance of tumor progression.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic Management of Craniopharyngiomas

Pollock

Natt²,

Schomberg

2002

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Eleven patients with craniopharyngiomas underwent 13 stereotactic procedures (intracavitary irradiation, n = 7; radiosurgery, n = 6). Nine patients (82%) had recurrent tumors after prior surgery (median, 2 operations). The median patient age was 50 years (range, 6–63 years). At a median follow-up of 38 months (range, 24–102 months), no patient had progression of the treated tumor component. Two patients developed new cysts, so the actuarial 2- and 4-year progression-free survival rates were 91 and 73%, respectively. Visual function improved in 3 patients, remained stable in 6 patients, and worsened in 1 patient. Two patients (both without prior surgery) not having diabetes insipidus pre-operatively continued to have normal posterior pituitary function. Stereotactic techniques should be considered for patients with craniopharyngiomas, especially those who have failed prior surgical resection.

show abstract

“…[19] It is of note that no deaths were reported in our patients. Both longterm cure rate and long-term recurrence rate were reported high (82% and 18% respectively [10,28,33] ). Somewhat lower rates are also observed: the ten-yearsurvival, progression-free and event-free survival rates were 65%, 39% and 29%, respectively.…”

Section: Discussionmentioning

confidence: 98%

“…[5,16,19,[28][29][30][31] Operative mortality was reported at 2.4%, [32] 3.7%, [30] and 7.4%. [33] In addition, more postoperative deaths (9/51 children; 2 following the relapse procedure) were also reported. [19] It is of note that no deaths were reported in our patients.…”

Section: Discussionmentioning

confidence: 99%