The impact of the site of origin and rate of tumour growth on clinical outcome in children with craniopharyngiomas

Qi, Songtao; Lu, Yuntao; Gao, Fang; Cao, Ying; Peng, Junxiang; Zhang, Xian

doi:10.1111/j.1365-2265.2011.04172.x

Cited by 24 publications

(20 citation statements)

References 31 publications

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“…They found that the tumors in 14 (56%) patients had characteristics of the infradiaphragmatic subtype, including prechiasmatic growth and a layer of sellar diaphragm covering the tumor top, whereas the tumors in the other 11 patients had retrochiasmatic growth and a centered TVF. Lena 50 Interestingly, none of these studies included an extraventricular subtype in the tumor classification. Few studies have specifically addressed Id-CPs in adult patients, which is most likely because of their rarity in the adult population.…”

Section: Differences In Growth Patterns Between Juvenile and Adult Casesmentioning

confidence: 99%

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: 99%

Growth patterns of craniopharyngiomas: clinical analysis of 226 patients

Pan¹,

Qi²,

Liu³

et al. 2016

PED

Self Cite

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“…These scores indicate that most of the included studies were of moderate quality. Quality was predominately limited by missing or incomplete information about VA testing and/or VF testing [ 14 , 19 , 26 – 28 , 30 , 33 – 35 , 51 , 54 – 56 , 62 , 67 , 68 , 70 , 74 , 77 , 85 , 93 , 97 , 100 , 104 , 108 ]. Other important reasons for weaker quality were studies who included only patients who are known to have an impaired visual function [ 83 , 100 ], studies who included only patients who are known to have a CP at a specific location [ 46 , 54 , 71 , 75 , 76 , 80 , 81 , 86 , 108 ] and studies who included only patients with giant or extensive CP [ 46 , 67 , 79 , 99 , 104 ].…”

Section: Resultsmentioning

confidence: 99%

Visual functions in children with craniopharyngioma at diagnosis: A systematic review

et al. 2020

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Childhood craniopharyngioma is a rare and slow growing brain tumour, often located in the sellar and suprasellar region. It commonly manifests with visual impairment, increased intracranial pressure and hypothalamic and/or pituitary deficiencies. Visual impairment in childhood adversely affects a child's daily functioning and quality of life. We systematically reviewed the literature to provide an extensive overview of the visual function in children with craniopharyngioma at diagnosis in order to estimate the diversity, magnitude and relevance of the problem of visual impairment. Of the 543 potentially relevant articles, 84 studies met our inclusion criteria. Visual impairment at diagnosis was reported in 1041 of 2071 children (50.3%), decreased visual acuity was reported in 546 of 1321 children (41.3%) and visual field defects were reported in 426 of 1111 children (38.3%). Other ophthalmological findings described were fundoscopic (32.5%) and orthoptic abnormalities (12.5%). Variations in ophthalmological testing methods and ophthalmological definitions precluded a meta-analysis. The results of this review confirm the importance of ophthalmological examination in children with craniopharyngioma at diagnosis in order to detect visual impairment and provide adequate support. Future studies should focus on long-term visual follow-up of childhood craniopharyngioma in response to different treatment strategies to provide insight in risks and ways to prevent further loss of vision.

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“…For a prospective cohort study, patients were selected according to inclusion and exclusion criteria. The inclusion criteria were as follows: (i) primary surgical removal in our department; (ii) no preoperative or postoperative radiotherapy or chemotherapy; (iii) suprasellar infundibulo-tuberal CPs with the probable site of origin being the tubero-infundibulum, with growth in the third ventricular floor; [11][12][13] (iv) degree of hypothalamic involvement of the tumours as described by Puget et al, 14 the hypothalamus being no longer identifiable; (v) operative plans determined and operative procedures performed by the same neurosurgeons in the Nanfang Hospital; (vi) surgical resection with the aim of total tumour removal; (vii) residual tumour not evident by magnetic resonance imaging (MRI) 72 h after surgery; and (viii) willingness to comply with the follow-up schedule. The exclusion criteria were as follows: (i) preoperative or postoperative chemotherapy and radiotherapy; (ii) unidentified cause of death or postoperative death owing to other identified causes not related to CPs; (iii) lost to follow-up or follow-up period of <24 months; (iv) CPs were exclusively intrasellar tumours.…”

Section: Materials and Methods Patients And Tissue Specimensmentioning

confidence: 99%

Epithelial–mesenchymal transition and clinicopathological correlation in craniopharyngioma

Zhou

Zhang

et al. 2012

Histopathology

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The impact of the site of origin and rate of tumour growth on clinical outcome in children with craniopharyngiomas

Abstract: Substantial differences in the outcome of childhood CP with different tumour growth patterns and locations were found, which suggested that diverse therapeutic considerations, especially endocrinological substitution, might be emphasized.

Cited by 24 publications

References 31 publications

Growth patterns of craniopharyngiomas: clinical analysis of 226 patients

Growth patterns of craniopharyngiomas: clinical analysis of 226 patients

Visual functions in children with craniopharyngioma at diagnosis: A systematic review

Epithelial–mesenchymal transition and clinicopathological correlation in craniopharyngioma

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