Expression of Angiogenic Factors in Craniopharyngiomas

Sun, Halil İbrahim; Akgun, Emel; Biçer, Atilla; Ozkan, Abdulkadir; Bozkurt, Süheyla; Kurtkaya, Özlem; Koç, Demet; Pamir, M. Necmettin; Kılıç, Türker

doi:10.1227/01.neu.0000367553.65099.14

Cited by 25 publications

(20 citation statements)

References 45 publications

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“…Better outcome in younger patients, 7,22,59 better outcome in older patients, 8,51 and similar outcome between younger and older patients 31,42,47,48 have all been reported. These contradictory data warrant cautious interpretation, as a detailed topographic comparison of CPs between adults and children was not provided in most of these studies.…”

Section: Differences In Growth Patterns Between Juvenile and Adult Casesmentioning

confidence: 64%

Growth patterns of craniopharyngiomas: clinical analysis of 226 patients

Pan¹,

Qi²,

Liu³

et al. 2016

PED

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OBJECT Craniopharyngiomas (CPs) are rare epithelial tumors that are often associated with an enigmatic and unpredictable growth pattern. Understanding the growth patterns of these tumors has a direct impact on surgical planning and may enhance the safety of radical tumor removal. The aim of this study was to analyze the growth patterns and surgical treatment of CPs with a focus on the involvement of the hypothalamopituitary axis and the relationship of the tumor to the arachnoid membrane and surrounding structures. METHODS Clinical data from 226 consecutive patients with primary CP were retrospectively reviewed. Tumor location and the relationship of the tumor to the third ventricle floor and the pituitary stalk were evaluated using preoperative MRI and intraoperative findings. A topographic classification scheme was proposed based on the site of tumor origin and tumor development. The clinical relevance of this classification on patient presentation and outcomes was also analyzed. RESULTS The growth of CPs can be broadly divided into 3 groups based on the site of tumor origin and on tumor-meningeal relationships: Group I, infrasellar/infradiaphragmatic CPs (Id-CPs), which mainly occurred in children; Group II, suprasellar subarachnoid extraventricular CPs (Sa-CPs), which were mainly observed in adults and rarely occurred in children; and Group III, suprasellar subpial ventricular CPs (Sp-CPs), which commonly occurred in both adults and children. Tumors in each group may develop complex growth patterns during vertical expansion along the pituitary stalk. Tumor growth patterns were closely related to both clinical presentation and outcomes. Patients with Sp-CPs had more prevalent weight gain than patients with Id-CPs or Sa-CPs; the rates of significant weight gain were 41.7% for children and 16.7% for adults with Sp-CPs, 2.2% and 7.1% for those with Id-CPs, and 12.5% and 2.6% for those with Sa-CPs (p < 0.001). Moreover, patients with Sp-CPs had increased hypothalamic dysfunction after radical removal; 39% of patients with Sp-CPs, 14.5% with Id-CPs, and 17.4% with Sa-CPs had high-grade hypothalamic dysfunction in the first 2 postoperative years (p < 0.001). CONCLUSIONS The classification of CPs based on growth pattern may elucidate the best course of treatment for this formidable tumor. More tailored, individualized surgical strategies based on tumor growth patterns are mandatory to provide long-term tumor control and to minimize damage to hypothalamic structures. Differences in the distribution of growth patterns between children and adults imply that hierarchical comparison is necessary when investigating outcomes and survival across treatment paradigms in patients with CP.

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Section: Differences In Growth Patterns Between Juvenile and Adult Casesmentioning

confidence: 64%

Growth patterns of craniopharyngiomas: clinical analysis of 226 patients

Pan¹,

Qi²,

Liu³

et al. 2016

PED

View full text Add to dashboard Cite

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“…Angiogenic and hormonal factors and mutations associated with genes involved in ectodermal development have been investigated. These studies showed that expression of PDGFR-alpha and FGF-2 were noted to be significantly higher in tissue specimens taken from patients with recurrent tumors (13). Ki-67 labeling index was significantly higher in patients with tumor progression and the incidence of post-operative regrowth was higher in patients negative for estrogen and progesterone receptors compared to those who were positive for both receptors (14).…”

Section: Discussionmentioning

confidence: 99%

Disease Control After Reduced Volume Conformal and Intensity Modulated Radiation Therapy for Childhood Craniopharyngioma

Merchant

Kun

Hua

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

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PURPOSE To estimate the rate of disease control after conformal radiation therapy using reduced clinical target volume (CTV) margins and determine factors that predict for tumor progression. METHODS AND MATERIALS Eighty-eight children (median age 8.5 years, range 3.2–17.6 years) received conformal or intensity-modulated radiation therapy between 1998 and 2009. This included those prospectively treated from 1998 to 2003 using a 10 mm CTV, defined as the margin surrounding the solid and cystic tumor targeted to receive the prescription dose of 54 Gy. The CTV margin was subsequently reduced after 2003 yielding two groups of patients: those treated with a CTV margin greater than 5 mm (n=26) and those treated with a CTV margin less than or equal to 5 mm (n=62). Disease progression was estimated on the basis of additional variables including sex, race, extent of resection, tumor interventions, target volume margins, and the frequency of weekly surveillance MR imaging during radiation therapy. The median follow-up was 5 years. RESULTS There was no difference comparing progression-free survival based on CTV margin (>5mm vs. ≤ 5mm) at 5 years, 88.1 + 6.3% vs. 96.2 + 4.4% (P=0.6386). There was no difference based on the planning target volume (PTV) margin (or combined CTV+PTV). The PTV was systematically reduced from 5 to 3mm during the time period of the study. Factors predictive of superior progression-free survival included Caucasian race (P=0.0175), absent CSF shunting requirement (P=0.0066), and the number of surveillance imaging studies during treatment (P=0.0216). Patients whose treatment protocol included a higher number of weekly surveillance MR imaging evaluations had a lower rate of tumor progression. CONCLUSIONS These results suggest that targeted volume reductions for radiation therapy using smaller margins are feasible and safe but require careful monitoring. We are currently investigating the differences in outcome based on host factors to explain the results.

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“…2,13,51,[55][56][57] One functional study using a corneal angiogenesis assay revealed that recurrent ACP samples had a significantly higher angiogenic potential than nonrecurrent ACP, but less than glioblastoma multiforme or arteriovenous malformations. 51 Imatinib-loaded microspheres reduced neovascularization in this model, but the use of this or other antiangiogenic approaches in patients has not been reported in the literature.…”

Section: Molecular Biology Of Tumor-associated Angiogenesismentioning

confidence: 99%

Molecular pathology of adamantinomatous craniopharyngioma: review and opportunities for practice

Apps¹,

Martinez-Barbera²

2016

FOC

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Since the first identification of CTNNB1 mutations in adamantinomatous craniopharyngioma (ACP), much has been learned about the molecular pathways and processes that are disrupted in ACP pathogenesis. To date this understanding has not translated into tangible patient benefit. The recent development of novel techniques and a range of preclinical models now provides an opportunity to begin to support treatment decisions and develop new therapeutics based on molecular pathology. In this review the authors summarize many of the key findings and pathways implicated in ACP pathogenesis and discuss the challenges that need to be tackled to translate these basic science findings for the benefit of patients.

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Expression of Angiogenic Factors in Craniopharyngiomas

Abstract: These findings suggest a relationship between recurrence of craniopharyngiomas and angiogenesis. New treatment modalities with selective PDGFR-alpha blockers may represent a novel and effective therapeutic option for the treatment of craniopharyngiomas.

Cited by 25 publications

References 45 publications

Growth patterns of craniopharyngiomas: clinical analysis of 226 patients

Growth patterns of craniopharyngiomas: clinical analysis of 226 patients

Disease Control After Reduced Volume Conformal and Intensity Modulated Radiation Therapy for Childhood Craniopharyngioma

Molecular pathology of adamantinomatous craniopharyngioma: review and opportunities for practice

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