The management of craniopharyngioma

Twenty-six patients with proven craniopharyngioma were treated between 1954 and 1977. Total surgical removal was achieved in three patients (11.5%). Tumour recurrence was inevitable following incomplete surgical removal alone. Fifteen patients received post-operative radiotherapy following incomplete surgical removal of the tumour and eight patients (54%) survived, recurrence-free, for 5 years or more. Post-operative radiotherapy, delivering a central target absorbed dose of 4500 cGy in 20 fractions over 28 days (1520 rets) or more, significantly improved the recurrence-free survival (P = 0.019) with minimal morbidity. Partial resection of recurrent tumour carried a high mortality rate. Minimal salvage surgery in the form of cyst aspiration sometimes resulted in worthwhile palliation.