Clinical and oncological outcomes in single-stage versus staged surgery for pediatric craniopharyngiomas: a multicenter retrospective study
Agresta G, Campione A, Veiceschi P, Gallo D, Agosti E, Massimi L, Piatelli G, Consales A, Linsler S, Oertel J, Pozzi F, Tanda ML, Castelnuovo P, Locatelli D (2023)
Publication Type: Journal article
Publication year: 2023
Journal
Book Volume: 46
Pages Range: 1219-1232
Journal Issue: 6
DOI: 10.1007/s40618-022-01993-2
Abstract
Purpose: Craniopharyngiomas (CPGs) are aggressive brain tumors responsible of severe morbidity in children. The best treatment strategies are under debate. Our study evaluates surgical, pituitary, and hypothalamic outcomes of a tailored staged-surgical approach compared to a single-stage radical approach in children with CPGs. Methods: Multicenter retrospective study enrolling 96 children treated for CPGs in the period 2010–2022. The surgical management was selected after a multidisciplinary evaluation. Primary endpoint includes the inter-group comparison of preservation/improvement of hypothalamic–pituitary function, the extent of resection, and progression-free survival (PFS). Secondary endpoints include overall survival (OS), morbidity, and quality of life (QoL). Results: Gross Total Resection (GTR) was reached in 46.1% of cases in the single-stage surgery group (82 patients, age at surgery 9 ± 4.7 years) and 33.3% after the last operation in the staged surgery group (14 patients age 7.64 ± 4.57 years at first surgery and 9.36 ± 4.7 years at the last surgery). The PFS was significantly higher in patients addressed to staged- compared to single-stage surgery (93.75% vs 70.7% at 5 years, respectively, p = 0.03). The recurrence rate was slightly higher in the single-stage surgery group. No significant differences emerged in the endocrinological, visual, hypothalamic outcome, OS, and QoL comparing the two groups. Conclusions: In pediatric CPGs’ surgical radicality and timing of intervention should be tailored considering both anatomical extension and hypothalamic–pituitary function. In selected patients, a staged approach offers a safer and more effective disease control, preserving psychophysical development.
Authors with CRIS profile
Involved external institutions
University of Insubria / Università degli Studi dell'Insubria
Italy (IT)
Catholic University of the Sacred Heart / Università Cattolica del Sacro Cuore
Italy (IT)
Istituto Giannina Gaslini
Italy (IT)
Universitätsklinikum des Saarlandes (UKS)
Germany (DE)
Italy (IT)
Catholic University of the Sacred Heart / Università Cattolica del Sacro Cuore
Italy (IT)
Istituto Giannina Gaslini
Italy (IT)
Universitätsklinikum des Saarlandes (UKS)
Germany (DE)
How to cite
APA:
Agresta, G., Campione, A., Veiceschi, P., Gallo, D., Agosti, E., Massimi, L.,... Locatelli, D. (2023). Clinical and oncological outcomes in single-stage versus staged surgery for pediatric craniopharyngiomas: a multicenter retrospective study. Journal of Endocrinological Investigation, 46(6), 1219-1232. https://doi.org/10.1007/s40618-022-01993-2
MLA:
Agresta, G., et al. "Clinical and oncological outcomes in single-stage versus staged surgery for pediatric craniopharyngiomas: a multicenter retrospective study." Journal of Endocrinological Investigation 46.6 (2023): 1219-1232.
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