Hafez Mohamed A, ElMekkawy Sherif, AbdelBadie Hazem, Mohy Mohamed, Omar Mohamed
Department of Neurosurgery, Cairo University Hospitals, Cairo, Egypt.
J Pediatr Endocrinol Metab. 2006 Apr;19 Suppl 1:371-80.
Situated in a suprasellar location, craniopharyngiomas produce devastating endocrinological manifestations, visual impairment, and raised intracranial pressure, presenting a formidable disease entity for the neurosurgeon as well as the 'craniopharyngioma team'.
To evaluate direct postoperative and long-term results based on the extent of surgical removal and administration of radiotherapy.
Sixty-two new cases of pediatric craniopharyngioma were divided into three groups according to extent of removal: A (complete), B (subtotal), and C (partial). Groups A and B receiving primary postoperative radiotherapy were tagged groups Ar and Br.
Group A had significantly less recurrence rate than group B (p < 0.005); however, direct postoperative morbidity and mortality were worse (p < 0.05). Group C fared worse than the other two groups. In groups A and B with recurrence and in groups Ar and Br, radiotherapy provided long-term control.
The aim at first surgery should be total removal. Subtotal removal is warranted for more resilient tumors, while partial removal should be avoided as it provides poor results. Adjuvant radiotherapy is a useful tool in providing long-term tumor control.
颅咽管瘤位于鞍上部位，可产生严重的内分泌表现、视力损害及颅内压升高，对神经外科医生及“颅咽管瘤治疗团队”而言是一种棘手的疾病。
基于手术切除范围及放疗应用评估术后直接疗效及长期疗效。
62例儿童颅咽管瘤新病例根据切除范围分为三组：A组（全切）、B组（次全切除）和C组（部分切除）。接受术后初始放疗的A组和B组分别标记为Ar组和Br组。
A组复发率显著低于B组（p < 0.005）；然而，术后直接并发症发生率和死亡率更高（p < 0.05）。C组情况比其他两组更差。在复发的A组和B组以及Ar组和Br组中，放疗可实现长期控制。
首次手术的目标应为全切。对于更具韧性的肿瘤，次全切除是必要的，而应避免部分切除，因为其效果不佳。辅助放疗是实现长期肿瘤控制的有效手段。
