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Neuro Oncol. 2013 Jun;15(6):767-74. doi: 10.1093/neuonc/not026. Epub 2013 Mar 13.

Trends in treatment and outcomes of pediatric craniopharyngioma, 1975-2011.

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1
Division of Endocrinology, The Hospital for Sick Children, 555 University Ave. Toronto, Ontario, Canada M5G1X8.

Abstract

BACKGROUND:

Craniopharyngioma tumors and their treatment can lead to significant long-term morbidity due to their proximity to vital structures. The optimal treatment has been debated for many years. We aimed to review the long-term outcomes of children treated for craniopharyngioma in our institution over the past decade and describe trends in treatment and outcomes over the past 3 decades.

METHODS:

Charts of children with craniopharyngioma treated and followed at The Hospital for Sick Children between 2001 and 2011 were reviewed. Data regarding findings at diagnosis, treatment, and long-term outcomes were analyzed. Comparison was made with previously published data from our institution.

RESULTS:

Data from 33 patients are included; mean age at treatment, 10.7 ± 4.8 years. In 18 children (55%), the initial surgical approach was tumor cyst decompression with or without adjuvant therapy, compared with only 0-2% in the preceding decades (P < .01). Diabetes insipidus occurred in 55% of children and panhypopituitarism in 58% compared with 88% (P < .01) and 86% (P < .01), respectively, in the previous 10 years. Overall, there was a 36% reduction in the number of children who developed severe obesity compared with the preceding decade. Body mass index at follow-up was associated with body mass index at diagnosis (P = .004) and tumor resection as an initial treatment approach (P = .028).

CONCLUSIONS:

A shift in surgical treatment approach away from gross total resection has led to improved endocrine outcomes. This may have beneficial implications for quality of life in survivors.

KEYWORDS:

craniopharyngioma; hypothalamic obesity; interferon alpha; intracystic chemotherapy; pediatrics

PMID:
23486689
PMCID:
PMC3661103
DOI:
10.1093/neuonc/not026
[Indexed for MEDLINE]
Free PMC Article
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