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Titolo:
Surgical treatment of craniopharyngiomas: experience with 168 patients
Autore:
Fahlbusch, R; Honegger, J; Paulus, W; Huk, W; Buchfelder, M;
Indirizzi:
Univ Erlangen Nurnberg, Dept Neurosurg, D-91054 Erlangen, Germany Univ Erlangen Nurnberg Erlangen Germany D-91054 -91054 Erlangen, Germany Univ Erlangen Nurnberg, Dept Pathol, D-91054 Erlangen, Germany Univ Erlangen Nurnberg Erlangen Germany D-91054 -91054 Erlangen, Germany
Titolo Testata:
JOURNAL OF NEUROSURGERY
fascicolo: 2, volume: 90, anno: 1999,
pagine: 237 - 250
SICI:
0022-3085(199902)90:2<237:STOCEW>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHILDHOOD CRANIOPHARYNGIOMA; CYSTIC CRANIOPHARYNGIOMAS; RADIATION-THERAPY; MANAGEMENT; SURGERY; RADIOTHERAPY; IRRADIATION; MORBIDITY; CHILDREN; REMOVAL;
Keywords:
craniopharyngioma; surgical approach; operative technique; outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Fahlbusch, R Univ1054angen Nurnberg, Dept Neurosurg, Schwabachanlage 6 Kopfklinikum, D-9 Univ Erlangen Nurnberg Schwabachanlage 6 Kopfklinikum Erlangen Germany D-91054
Citazione:
R. Fahlbusch et al., "Surgical treatment of craniopharyngiomas: experience with 168 patients", J NEUROSURG, 90(2), 1999, pp. 237-250

Abstract

Object. The goal of this study was to assess the outcome of surgical management in 168 consecutive patients harboring craniopharyngiomas treated between January 1983 and April 1997. Methods. In 148 patients undergoing initial (primary) surgery, the pterional approach was most frequently used (39.2%), followed by the transsphenoidal approach (23.6%). For large retrochiasmatic craniopharyngiomas, the bifrontal interhemispheric approach was used increasingly over the pterional approach and led to improved surgical results. Total tumor removal was accomplished in 45.7% of transcranial and 85.7% of transsphenoidal procedures. The main reasons for incomplete removal were attachment to and/or infiltration of the hypothalamus, major calcifications, and attachment to vascular structures. The success rate in total tumor removal was inferior in the cases of tumor recurrence. The operative mortality rate in transcranial surgery was 1.1% in primary cases and 10.5% in cases of tumor recurrence. No patientdied in the group that underwent transsphenoidal surgery. The rate of recurrence-free survival after total removal was 86.9% at 5 years and 81.3% at 10 years. In contrast, the 5-year recurrence-free survival rate was only 48.8% after subtotal removal and 41.5% after partial removal. Following primary surgery, the actuarial survival rate was 92.7% at 10 years, with the best results after complete tumor removal. At last follow up, 117 (79%) of 148patients who underwent primary surgery were independent and without impairment. Conclusions. Total tumor removal while avoiding hazardous intraoperative manipulation provides favorable early results and a high rate of long-term control in craniopharyngiomas.

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Documento generato il 01/12/20 alle ore 07:45:15