Journal of Korean Neurosurgical Society

  • 제52권1호
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  • Pages.37-41
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  • 2012
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Treatment Outcomes of Pediatric Craniopharyngioma : A 15-Year Retrospective Review of 35 Cases

  • Jo, Kwang-Wook (Department of Neurosurgery, The Catholic University of Korea College of Medicine, Bucheon St. Mary's Hospital) ;
  • Shin, Hyung-Jin (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kong, Doo-Sik (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Seol, Ho-Jun (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Nam, Do-Hyun (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Jung-Il (Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2011.11.01
  • 심사 : 2012.04.15
  • 발행 : 2012.07.28
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초록

Objective : The aim of this study was to describe a single center's experience in the management of craniopharyngiomas in children over a 15-year period. Methods : The clinical records of pediatric patients treated for craniopharyngiomas between December 1995 and February 2011 were reviewed. Thirty-five pediatric patients diagnosed with craniopharyngioma were treated, and their medical records and imaging data were analyzed retrospectively. Results : The mean follow-up duration was 76 months (range, 10-195). Overall survival and local control rates at 10 years were $94.7{\pm}5.1%$ and $37.1{\pm}11.9%$, respectively. The female-to-male ratio was 16 : 19, and the mean age was 8.6 years (range, 1-17). Initially, gross total resection (GTR) was performed in 30 patients; subtotal resection (STR) followed by radiotherapy was performed in 5 patients. Of the 14 cases that showed recurrence after GTR, 5 patients were treated with GTR, 1 with radiation therapy (RT), 4 with gamma knife radiosurgery (GKRS), and 4 with subtotal resection followed by RT. No patients who underwent RT or GKRS had recurrences. Two cases with recurrence after STR followed by RT were treated with GTR. One patient died of hormonal insufficiency 64 months after the first surgery. The overall median time progression was 51.2 months (range, 3-182) : 49.7 months in the patients who underwent GTR and 60.2 months in the patients who underwent STR followed by RT. Conclusion : If safe resection is possible, GTR at the initial treatment should be attempted to reduce the tumor recurrence. However, if the tumor recurs after the first surgery, RT or GKRS with/without reoperation may be an effective salvage treatment for recurrent craniopharyngioma.

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참고문헌

  1. Aquilina K, Merchant TE, Rodriguez-Galindo C, Ellison DW, Sanford RA, Boop FA : Malignant transformation of irradiated craniopharyngioma in children : report of 2 cases. J Neurosurg Pediatr 5 : 155-161, 2010 https://doi.org/10.3171/2009.9.PEDS09257
  2. Chung WY, Pan DH, Shiau CY, Guo WY, Wang LW : Gamma knife radiosurgery for craniopharyngiomas. J Neurosurg 93 Suppl 3 : 47-56, 2000
  3. Elliott RE, Hsieh K, Hochm T, Belitskaya-Levy I, Wisoff J, Wisoff JH : Efficacy and safety of radical resection of primary and recurrent craniopharyngiomas in 86 children. J Neurosurg Pediatr 5 : 30-48, 2010
  4. Fahlbusch R, Honegger J, Paulus W, Huk W, Buchfelder M : Surgical treatment of craniopharyngiomas : experience with 168 patients. J Neurosurg 90 : 237-250, 1999 https://doi.org/10.3171/jns.1999.90.2.0237
  5. Fisher PG, Jenab J, Gopldthwaite PT, Tihan T, Wharam MD, Foer DR, et al. : Outcomes and failure patterns in childhood craniopharyngiomas. Childs Nerv Syst 14 : 558-563, 1998 https://doi.org/10.1007/s003810050272
  6. Gupta DK, Ojha BK, Sarkar C, Mahapatra AK, Sharma BS, Mehta VS : Recurrence in pediatric craniopharyngiomas : analysis of clinical and histological features. Childs Nerv Syst 22 : 50-55, 2006 https://doi.org/10.1007/s00381-005-1171-z
  7. Habrand JL, Ganry O, Couanet D, Rouxel V, Levy-Piedbois C, Pierre-Kahn A, et al. : The role of radiation therapy in the management of craniopharyngioma : a 25-year experience and review of the literature. Int J Radiat Oncol Biol Phys 44 : 255-263, 1999 https://doi.org/10.1016/S0360-3016(99)00030-9
  8. Haupt R, Magnani C, Pavanello M, Caruso S, Dama E, Garrè ML : Epidemiological aspects of craniopharyngioma. J Pediatr Endocrinol Metab 19 Suppl 1 : 289-293, 2006
  9. Kalapurakal JA : Radiation therapy in the management of pediatric craniopharyngiomas--a review. Childs Nerv Syst 21 : 808-816, 2005 https://doi.org/10.1007/s00381-005-1188-3
  10. Kalapurakal JA, Goldman S, Hsieh YC, Tomita T, Marymont MH : Clinical outcome in children with craniopharyngioma treated with primary surgery and radiotherapy deferred until relapse. Med Pediatr Oncol 40 : 214-218, 2003 https://doi.org/10.1002/mpo.10247
  11. Kobayashi T : Long-term results of gamma knife radiosurgery for 100 consecutive cases of craniopharyngioma and a treatment strategy. Prog Neurol Surg 22 : 63-76, 2009
  12. Lin LL, El Naqa I, Leonard JR, Park TS, Hollander AS, Michalski JM, et al. : Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatr 1 : 126-130, 2008 https://doi.org/10.3171/PED/2008/1/2/126
  13. Merchant TE, Kiehna EN, Sanford RA, Mulhern RK, Thompson SJ, Wilson MW, et al. : Craniopharyngioma : the St. Jude Children's Research Hospital experience 1984-2001. Int J Radiat Oncol Biol Phys 53 : 533-542, 2002 https://doi.org/10.1016/S0360-3016(02)02799-2
  14. Ohmori K, Collins J, Fukushima T : Craniopharyngiomas in children. Pediatr Neurosurg 43 : 265-278, 2007 https://doi.org/10.1159/000103306
  15. Parisi JE, Mena H : Nonglial tumours in Nelson JS, Parisi JE, Schochet SS (eds) : Principles and Practice of Neuropathology. St. Louis : Mosby, 1993, pp203-266
  16. Sammi M, Samii A : Craniopharyngioma in Kaye AH, Laws ER (eds) : Operative Neurosurgical Technique. Philadelphia : WB Sunders, 1995, pp357-370
  17. Schoenberg BS, Schoenberg DG, Christine BW, Gomez MR : The epidemiology of primary intracranial neoplasms of childhood. A population study. Mayo Clin Proc 51 : 51-56, 1976
  18. Schubert T, Trippel M, Tacke U, van Velthoven V, Gumpp V, Bartelt S, et al. : Neurosurgical treatment strategies in childhood craniopharyngiomas : is less more? Childs Nerv Syst 25 : 1419-1427, 2009 https://doi.org/10.1007/s00381-009-0978-4
  19. Varlotto JM, Flickinger JC, Kondziolka D, Lunsford LD, Deutsch M : External beam irradiation of craniopharyngiomas: long-term analysis of tumor control and morbidity. Int J Radiat Oncol Biol Phys 54 : 492-499, 2002 https://doi.org/10.1016/S0360-3016(02)02965-6
  20. Weiss M, Sutton L, Marcial V, Fowble B, Packer R, Zimmerman R, et al. : The role of radiation therapy in the management of childhood craniopharyngioma. Int J Radiat Oncol Biol Phys 17 : 1313-1321, 1989 https://doi.org/10.1016/0360-3016(89)90543-9
  21. Wen BC, Hussey DH, Staples J, Hitchon PW, Jani SK, Vigliotti AP, et al. : A comparison of the roles of surgery and radiation therapy in the management of craniopharyngiomas. Int J Radiat Oncol Biol Phys 16 : 17-24, 1989 https://doi.org/10.1016/0360-3016(89)90005-9

피인용 문헌

  1. Reply: Classification Systems of Adult Craniopharyngiomas: The Need for an Accurate Definition of the Hypothalamus-Tumor Relationships vol.43, pp.7, 2012, https://doi.org/10.1016/j.arcmed.2012.10.005
  2. Craniopharyngiomas : Radiological Differentiation of Two Types vol.59, pp.5, 2016, https://doi.org/10.3340/jkns.2016.59.5.466
  3. Neurosurgery concepts: Key perspectives on endoscopic versus microscopic resection for pituitary adenomas, surgical decision-making in tuberculum sellae meningiomas, optic nerve mobilization during re vol.8, pp.1, 2012, https://doi.org/10.4103/sni.sni_17_17
  4. Clinical, Pathological and Surgical Risk Factors Associated with Craniopharyngioma Recurrence: A Literature Review vol.9, pp.1, 2012, https://doi.org/10.4236/ojmn.2019.91008