Article
Surgical treatment for recurrent craniopharyngiomas: long-term outcomes in a pure surgical series
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Published: | May 8, 2006 |
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Objective: The goal of this study was to analyze retrospectively a consecutive series of craniopharyngiomas and their recurrence treated by our policy of surgical management first.
Methods: In the past 20 years, 40 consecutive patients with craniopharyngioma underwent surgical treatment without radiation therapy. In this series, there no patient received radiation therapy because the strategy during the 20 years was so consistent that surgical management was the first choice of treatment whenever possible.
Results: Among these 40 cases, 13 patients showed tumour recurrence during the mean follow-up period of 12 years. Among these 13 patients, 7 patients had recurrence after total radiological removal and 6 patients had recurrence with partial or incomplete removal. For these 13 patients, surgical removal was performed 19 times. Using a proper surgical approach (mainly a basal interhemispheric approach) and meticulous microsurgical techniques, total removal of the recurrent tumour was achieved in 10 surgeries, and the surgical mortality was 0% and morbidity was 9.1%. In most cases, visual function was preserved or improved and intellectual performance was also preserved.
Conclusions: Recurrence of craniopharyngioma can be safely managed by meticulous contemporary microsurgery without additional radiation therapy. The role of surgery and the adjuvant radiation therapy for craniopharyngiomas may vary in the future, depending on the progress of the modality of treatment and technology. However surgery can be still a major therapeutic option in the management of recurrent craniopharyngiomas.