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.


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.


CONCLUSIONS
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.
Hafez
Mohamed A
MA
Department of Neurosurgery, Cairo University Hospitals, Cairo, Egypt. dindinosi@hotmail.com
ElMekkawy
Sherif
S
AbdelBadie
Hazem
H
Mohy
Mohamed
M
Omar
Mohamed
M
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003397:Craniopharyngioma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D004534:Egypt; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures; D010911:Pituitary Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D011788:Quality of Life; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome