title: Influence of previous treatments on repeat surgery for recurrent craniopharyngiomas in children.
abstract: OBJECTIVE
  Craniopharyngioma is a common pediatric brain tumor, with a high rate of recurrence after primary treatment. This retrospective study investigated the effect of various primary treatments on surgical strategies and outcomes for recurrent craniopharyngiomas.
  
  
  METHODS
  The study population comprised 35 children (mean age 8.77 years, range 1-16 years) with recurrent craniopharyngioma re-operated from January 1990 to January 2009. The recurrent craniopharyngiomas were excised whenever possible. For analysis, the patients were divided into four groups according to the primary treatment: radical tumor resection (A), incomplete tumor resection (B), radiotherapy + incomplete tumor resection (C), and Ommaya reservoir placement + incomplete tumor resection (D).
  
  
  RESULTS
  Group B had a significantly shorter recurrence-free interval than groups A, C, or D. Outcomes were significantly different among the four groups. The hypothalamic status scores of groups A (2.38 ± 0.27) and C (2.28 ± 0.42) were significantly higher than that of group B (1.64 ± 0.20). There were no statistical differences between any two other groups.
  
  
  CONCLUSIONS
  In children, the primary treatments for craniopharyngioma should be considered when choosing the surgical strategy for recurrence. Radiotherapy before repeated surgery can result in a worse functional outcome and hypothalamic-pituitary function.
authors.affiliation: Department of Neurosurgery, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Department of Neurosurgery, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Binghui
authors.initials: B
authors.lastname: Qiu
authors.affiliation: Department of Neurosurgery, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China. bobkuanci@hotmail.com.
authors.forename: Songtao
authors.initials: S
authors.lastname: Qi
authors.affiliation: Department of Neurosurgery, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Pan
authors.affiliation: Department of Neurosurgery, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Yuntao
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Neurosurgery, Nan Fang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
authors.forename: Junxiang
authors.initials: J
authors.lastname: Peng
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003397:Craniopharyngioma / Q000150:complications / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery; D019635:Neurosurgical Procedures; D010911:Pituitary Neoplasms / Q000150:complications / Q000628:therapy*; D011878:Radiotherapy; D012086:Reoperation / Q000401:mortality
chemical_list: D000970:Antineoplastic Agents
keywords: Benign tumor; Brain tumor; Craniopharyngioma; Pediatric; Pituitary gland; Recurrence