title: Patterns of care for craniopharyngioma: survey of members of the american association of neurological surgeons.
abstract: BACKGROUND
  Initial therapy for craniopharyngioma remains controversial. Population-based datasets indicate that traditional algorithms [gross total resection (GTR) vs. subtotal resection (STR) +/- radiation therapy (XRT)] are often not employed. We investigated neurosurgical practice patterns.
  
  
  METHODS
  A ten-question survey was electronically distributed to members of the American Association of Neurological Surgeons. Responses were analyzed using standard statistical techniques.
  
  
  RESULTS
  102 responses were collected, with a median of 25 craniopharyngiomas managed per respondent. 36% estimated that their practice included ≥75% pediatric patients and 61% had an academic practice. 36% would recommend observation or XRT for a suspected craniopharyngioma in the absence of a tissue diagnosis, with 46% of these indicating this recommendation in ≥10% of the cases. Following STR, 35% always recommend XRT and 59% recommend it in over half of the cases. However, following STR or biopsy alone, 18 and 11% never recommend XRT. There was no association between the type of practice (i.e. academic or ≥75% pediatric patients) and practice patterns.
  
  
  CONCLUSIONS
  This survey verifies that a deviation from established algorithms is common, underscoring the clinical complexity of these patients and recent secondary data analyses. This should influence clinical researchers to investigate outcomes for patients treated using alternative methods. It will lend insight into appropriate treatment options and contribute to quality of life outcomes studies for craniopharyngioma.
authors.affiliation: Pediatric Neurosurgery, Children's Hospital Colorado, University of Colorado Denver, Aurora, Colo., USA.
authors.forename: Todd C
authors.initials: TC
authors.lastname: Hankinson
authors.forename: Nicholas O
authors.initials: NO
authors.lastname: Palmeri
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Williams
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Torok
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Serrano
authors.forename: Nicholas K
authors.initials: NK
authors.lastname: Foreman
authors.forename: Michael H
authors.initials: MH
authors.lastname: Handler
authors.forename: Arthur K
authors.initials: AK
authors.lastname: Liu
mesh_terms: D003397:Craniopharyngioma / Q000175:diagnosis / Q000601:surgery*; D003625:Data Collection / Q000379:methods; D006801:Humans; D009462:Neurology / Q000379:methods*; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011364:Professional Practice; D012955:Societies, Medical; D066231:Surgeons; D014481:United States