[Craniopharyngiomas in adults and children. Study of a surgical series of 106 consecutive cases]

Abstract

This work is devoted to a 20-year retrospective study of 106 surgical cases of craniopharyngiomas in adults and children treated and followed by the same neurosurgeon. The mean follow-up was 7.2 years. In this homogeneous series, the aim was total microsurgical removal of the tumor, without post-operative radiotherapy. The operation was usually performed through a fronto-pterional approach, and, in some particular cases, through a transsphenoidal approach. The tumor removal was total in 59 cases, subtotal in 31 cases, partial in 16 cases. Even when the removal was not total, radiotherapy was not systematically administered, but was reserved for relapses. We have studied clinical signs, operation characteristics, ophthalmological, endocrinological and functional outcome, as well as recurrence risk and long-term survival. The functional results of our patients were excellent in 82%, good in 9%, fair in 8% (usually due to ophthalmological sequellae), and poor in 1%. Twenty-five patients recurred, but the salvage treatment, by reoperation or radiotherapy, was successful in almost 75%. The actuarial survival was 91% after 5 years, and 80% after 10 years. These results compare favorably with the literature data, suggesting that radical surgery of craniopharyngiomas allows good outcome in terms of survival, full recovery and quality of life, for both adults and children.