Pediatric craniopharyngioma--rationale for multimodal management: the Egyptian experience.

BACKGROUND

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'.

OBJECTIVE

To evaluate direct postoperative and long-term results based on the extent of surgical removal and administration of radiotherapy.

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.