Craniopharyngiomas: a critical approach to treatment

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Abstract
A retrospective statistical study was conducted in a series of 45 patients with craniopharyngiomas to assess the value of different therapeutic approaches. All study patients were placed in 3 groups according to their method of treatment: total excision; subtotal excision; and surgery followed by a course of radiotherapy (RT). Symptomatic recurrence was used to define failure of treatment. Of the patients subjected to total excision, 30% experienced recurrence after a mean time of 2 yr. Tumors recurred in 71% of those treated by subtotal excision, with a mean time of 2.6 yr. Of patients receiving RT in addition to surgery, only 6% had recurrence, after a mean time of 1 yr. The elective treatment for craniopharyngiomas apparently is controlled subtotal surgery plus RT. Total excision should be attempted only if there is a negligible danger of mortality.