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Complications in paediatric craniopharyngioma treatment
G Zuccaro1, R Jaimovich, B Mantese
1Juan P. Garrahan National Paediatric Hospital, Buenos Aires, Argentina.
Insights
Total craniopharyngioma resection in children offers better survival and quality of life than subtotal resection with radiotherapy, which has a high recurrence rate. Endocrinological complications were similar between groups.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Oncology
Background:
- Craniopharyngioma is a common pediatric brain tumor.
- Treatment strategies vary, impacting patient outcomes.
Purpose of the Study:
- To compare outcomes of total resection versus subtotal/partial resection plus radiotherapy in pediatric craniopharyngioma patients.
- To analyze complications, recurrence rates, survival, and quality of life.
Main Methods:
- Retrospective analysis of 48 pediatric craniopharyngioma patients treated between 1988-1994.
- Comparison of outcomes between patients undergoing total resection versus subtotal/partial resection with radiotherapy.
Main Results:
- Total resection group showed superior survival and quality of life with no recurrences.
- Subtotal/partial resection with radiotherapy had a 53% relapse rate.
- Endocrinological complications were similar; however, subdural hematomas and shunt malfunctions were frequent.
Conclusions:
- Total resection is associated with better long-term outcomes for pediatric craniopharyngioma.
- Radiotherapy following subtotal resection increases recurrence risk.
- Careful consideration of shunting strategies is needed due to high malfunction rates.
Abstract:
Forty-eight consecutive children treated for craniopharyngioma at the Juan P. Garrahan National Paediatric Hospital (Buenos Aires, Argentina) from 1988 to 1994 are described. Complications of patients undergoing total resection alone and those undergoing subtotal or partial resection plus radiotherapy were compared. Survival time and quality of life proved more satisfactory in the former group, as there were no recurrences. In contrast, among the latter patients, 53% suffered relapses. Endocrinological complications were similar in the two groups. Postsurgical subdural haematomas were quite frequent and eight patients required treatment for intracranial hypertension. Vascular complications, though less common, led to high morbidity and mortality. There was a considerable incidence of shunt malfunction (80%), arguing against placement of a preoperative shunt, which tended besides to foster postsurgical subdural haematomas.
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