gms | German Medical Science

63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

13. - 16. Juni 2012, Leipzig

Role of skull base surgery for the radical resection of craniopharyngioma

Meeting Abstract

Suche in Medline nach

  • K. Ohata - Department of Neurosurgery, Osaka City University, Osaka, Japan
  • K. Ishibashi - Department of Neurosurgery, Osaka City University, Osaka, Japan
  • N. Kunihiro - Department of Neurosurgery, Osaka City University, Osaka, Japan
  • T. Goto - Department of Neurosurgery, Osaka City University, Osaka, Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocMI.03.05

DOI: 10.3205/12dgnc009, URN: urn:nbn:de:0183-12dgnc0094

Veröffentlicht: 4. Juni 2012

© 2012 Ohata et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Our policy of treatment of craniopharyngiomas is radical tumor resection even in cases with recurrent lesions. We focus on the efficiency of skull base approaches for the radical resection of craniopharyngioma.

Methods: 63 consecutive patients (mean age, 39.9 yr; range, 4–74 yr) with craniopharyngioma, including 22 patients with recurrence, underwent 91 procedures at Osaka City University Hospital from 1993 to 2011. The best surgical corridor was selected from several skull base approaches depending on the individual variation including the tumor size, location, consistency and its extension. Surgical approaches included the transpetrosal approach 31 times, the orbitozygomatic approach in 33, the transsphenoidal approach in 10 and the subfrontal interhemispheric/basal approach in 13 and others in 2. The length of the follow-up ranged from 5 to 216 months (mean, 112).

Results: Gross total removal (no residual enhancement) was accomplished in 40 patients (64%), near total resection (thin rim or spot enhancement) in 21 (33%) and subtotal removal in 2 (3%). The reasons for incomplete removal were mainly involvement of vascular structures. The part of the tumor that adhered to the inferior surface of the chiasm was completely resected in all patients. Overall operative morbidity except for endocrinological function was 10% (6 patients), including 3 patients with cognitive dysfunction and 3 patients with visual deterioration. The ophthalmological function was significantly improved after operation. Using the Kaplan-Meier analysis, the cumulative recurrent-free survival rate was 85.2% after 5 years and 78.1% after 10 years.

Conclusions: Our satisfactory results suggest that the use of the skull base approaches can render the improvement of surgical outcomes in properly selected patients with craniopharyngioma, even in cases of recurrence.