Anzeige
Erschienen in:
10.07.2019 | Original Article
Sixty years single institutional experience with pediatric craniopharyngioma: between the past and the future
Erschienen in: Child's Nervous System | Ausgabe 2/2020
Einloggen, um Zugang zu erhaltenAbstract
Purpose
To demonstrate the paradigm shift in management strategies of pediatric craniopharyngioma at our institution over the past six decades.
Methods
Retrospective analysis of all pediatric patients with craniopharyngioma treated at Boston Children’s Hospital between 1960 and 2017.
Results
One hundred seventy-eight patients with craniopharyngioma were treated between 1960 and 2017; 135 (70 males and 65 females) fulfilled the inclusion criteria. Forty-five patients were treated in the old era (1960–1984) and 90 patients were treated in the new era (1985–2017). Gross total resection (GTR) was achieved in 4% and 43% of patients in old and new eras respectively. Sub-total resection (STR) and radiotherapy (XRT) were performed in 27% and 28% of patients in old and new eras respectively. STR without XRT was performed in 20% and 29% of patients in old and new era respectively. Cyst drainage and adjuvant radiotherapy were performed in 49% of patients in the old era while no patients in the new era underwent such conservative management. Aggressive surgical resection was associated with a higher risk of worsening visual outcomes (20% vs 16%), panhypopituitarism and diabetes insipidus (86% vs 53%), psycho-social impairment (42% vs 26%), and new-onset obesity (33% vs 22%). The mortality rate was higher in the old era in comparison with that of the new one (9% vs 2%).
Conclusion
There was a paradigm shift in management strategies of pediatric craniopharyngioma over the past six decades which in turn affected the long-term outcomes and quality of life of patients.