[Disease-free survival after surgical and combined treatment of newly diagnosed craniopharyngiomas in adults].

Abstract

Craniopharyngioma (CP) is a benign epithelial tumor predominantly localized in chiasmatic-sellar region and third ventricle. There are two histological variants of CP: adamantinoma-like (ACP, 85%) and papillomatous (PCP). These types differ significantly in origin and histological structure. PCP predominantly occurs in adults. Treatment of CP, including effectiveness of radiotherapy, is described in multiple studies and mainly devoted to pediatric patients.

Objective: To clarify disease-free survival in adults with newly diagnosed CP depending on resection quality; to evaluate the effectiveness of stereotactic irradiation and treatment depending on histological characteristics of tumor.

Material and methods: We analyzed treatment outcomes in 398 adults over 10-year follow-up. Stereotactic irradiation was performed in 11.6% of patients. The follow-up data were obtained in 68.1% of patients. We compared 5-year disease-free survival rates after different resections with and without subsequent irradiation.

Results: Total resection is effective and provides significantly lower risk of CP recurrence. Effectiveness of stereotactic irradiation after incomplete resection was also confirmed.

Conclusion: Total resection of ACP and PCP provides high disease-free survival rates. Stereotactic irradiation after incomplete resection is followed by similar outcomes. PCPs are characterized by less aggressive growth and do not recur after total resection.