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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Does the extent of surgical resection influence the quality of life in craniopharyngeoma patients?

Meeting Abstract

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  • Julia Onken - Abteilung für Neurochirurgie, CVK, Charité – Universitätsmedizin Berlin, Berlin
  • Wibke Jakob - Abteilung für Neurochirurgie, CVK, Charité – Universitätsmedizin Berlin, Berlin
  • Ulrich-Wilhelm Thomale - Abteilung für Neurochirurgie, CVK, Charité – Universitätsmedizin Berlin, Berlin
  • Peter Vajkoczy - Abteilung für Neurochirurgie, CVK, Charité – Universitätsmedizin Berlin, Berlin

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.10.06

doi: 10.3205/14dgnc325, urn:nbn:de:0183-14dgnc3258

Published: May 13, 2014

© 2014 Onken et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Craniopharyngeomas represent approximately 2.5–4% of all brain tumors. Their nature is usually benign. Whereas their adhesive growth to relevant structures like hypothalamus, thalamus and (neuro-) pituitary gland of suprasellar tumors is associated with severe pre- and postoperative complications. The aim of the study was to elucidate how radical surgical resection affects early and late complications and how this affects the quality of life of these patients.

Method: There was an analysis performed of 32 adult patients treated in our institution with a craniopharyngeoma. The quality of life was assessed in 14 patients with the EORTC questionnaire with a mean follow-up of 3.2 years after surgery. Disease related complications were assessed during follow-up in outpatient clinics. The extent of surgical resection was assessed based on the early postop MRI and intraoperative report.

Results: 29 out of 32 craniopharyngeoma patients were followed up within a period of 2.1 years after surgery in our institution. Overall survival was 87.5% within that period, none of them died due to surgical associated complications. 4 (12.5%) patients died in an average of 13.5 years after initial diagnosis. The complication rate due to surgery was 23%. 84% of the patients receiving gross total tumor resection (GTR) developed Diabetes insipidus (D.i.) within a few days after surgery. In the group of patients receiving partial tumor resection (PR) 45% suffered from D.i. 54% of the patients receiving PR had a tumor recurrence compared to 23% with GTR. 63% of the patients with GTR required long-term hormone substitution and 100% of the patients with PR. The subjective assessment of the health status and quality of life (EORTC questionnaire) showed no significant differences in both groups.

Conclusions: This study proofs that GTR of craniopharyngeomas leads to a lower recurrence rate compared to PR. After a mean follow-up of 3.2 years after surgery we see a decreased need of hormone substitution in patients with GTR. Furthermore there is no difference seen in subjective assessment of the health status and quality of life. Therefore we suggest that radical resection should be applied for adult patients with an initial diagnosis of a craniopharyngeoma.