Influence of previous treatments on repeat surgery for recurrent craniopharyngiomas in children

Childs Nerv Syst. 2016 Mar;32(3):485-91. doi: 10.1007/s00381-015-3003-0. Epub 2016 Jan 12.


Purpose: Craniopharyngioma is a common pediatric brain tumor, with a high rate of recurrence after primary treatment. This retrospective study investigated the effect of various primary treatments on surgical strategies and outcomes for recurrent craniopharyngiomas.

Methods: The study population comprised 35 children (mean age 8.77 years, range 1-16 years) with recurrent craniopharyngioma re-operated from January 1990 to January 2009. The recurrent craniopharyngiomas were excised whenever possible. For analysis, the patients were divided into four groups according to the primary treatment: radical tumor resection (A), incomplete tumor resection (B), radiotherapy + incomplete tumor resection (C), and Ommaya reservoir placement + incomplete tumor resection (D).

Results: Group B had a significantly shorter recurrence-free interval than groups A, C, or D. Outcomes were significantly different among the four groups. The hypothalamic status scores of groups A (2.38 ± 0.27) and C (2.28 ± 0.42) were significantly higher than that of group B (1.64 ± 0.20). There were no statistical differences between any two other groups.

Conclusions: In children, the primary treatments for craniopharyngioma should be considered when choosing the surgical strategy for recurrence. Radiotherapy before repeated surgery can result in a worse functional outcome and hypothalamic-pituitary function.

Keywords: Benign tumor; Brain tumor; Craniopharyngioma; Pediatric; Pituitary gland; Recurrence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antineoplastic Agents / therapeutic use
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Craniopharyngioma / complications
  • Craniopharyngioma / therapy*
  • Disease-Free Survival
  • Female
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Neoplasm Recurrence, Local* / mortality
  • Neoplasm Recurrence, Local* / surgery
  • Neurosurgical Procedures
  • Pituitary Neoplasms / complications
  • Pituitary Neoplasms / therapy*
  • Radiotherapy
  • Reoperation / mortality


  • Antineoplastic Agents