[Long-term result of the surgical treatment of craniopharyngiomas].
OBJECTIVE
The aim of the study was to assess the long-term outcome in patients with cranipharyngioma, depending on the extent of tumour removal.


METHODS
Thirty-six patients (17 females and 19 males), aged between 10 and 57, were treated at the Clinic of Neurosurgery of the Medical University of Warsaw between 1990 and 2004. The most common initial symptoms included: decreased visual acuity in 75% of cases, visual field defect in 69% of cases, headaches in 58% cases and endocrine disorders in 50% of cases. The initial diagnosis was based on two-phase computed tomography (CT) and magnetic resonance imaging (MRI). The most common means of surgical access was by pterional craniotomy, which was used in 27 cases. Due to tumour localisation, other accesses (bifrontal - basal, transventricular and transsphenoidal) were also used.


RESULTS
The tumour removal was considered total in 31%, subtotal in 38%, and partial in 31%. In the post-operational period 2 patients died. Control examinations were performed to investigate long-term outcome: two-phase MRI or CT, evaluations of visual acuity and visual field. During the follow-up period, tumour recurrence occurred in 1 patient (9%) following complete tumour removal, in 8 patients (57%) after subtotal removal, and in 6 patients (55%) after partial removal. The range of follow-up was between 2 and 14 years.


CONCLUSIONS
On the basis of our own experience we conclude that complete removal of the craniopharyngioma leads to the best outcome in terms of survival time and period free of recurrence. Clinical and radiological observation of the patients who underwent nonradical operation seems to be reasonable. In cases with tumour recurrence, reoperation and subsequent radiotherapy are advisable.
Bojanowski
Krzysztof
K
Klinika Neurochirurgii, Akademia Medyczna, Warszawa, Poland. kbojan@op.pl
Marchel
Andrzej
A
D000293:Adolescent; D000328:Adult; D002648:Child; D003397:Craniopharyngioma / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D015996:Survival Rate; D016896:Treatment Outcome