Trends in treatment and outcomes of pediatric craniopharyngioma, 19752011

Craniopharyngioma tumors and their treatment can lead to significant long-term morbidity due to their proximity to vital structures. The optimal treatment has been debated for many years. We aimed to review the long-term outcomes of children treated for craniopharyngioma in our institution over the past decade and describe trends in treatment and outcomes over the past 3 decades. Charts of children with craniopharyngioma treated and followed at The Hospital for Sick Children between 2001 and 2011 were reviewed. Data regarding findings at diagnosis, treatment, and long-term outcomes were analyzed. Comparison was made with previously published data from our institution. Data from 33 patients are included; mean age at treatment, 10.7 4.8 years. In 18 children (55), the initial surgical approach was tumor cyst decompression with or without adjuvant therapy, compared with only 02 in the preceding decades (P .01). Diabetes insipidus occurred in 55 of children and panhypopituitarism in 58 compared with 88 (P .01) and 86 (P .01), respectively, in the previous 10 years. Overall, there was a 36 reduction in the number of children who developed severe obesity compared with the preceding decade. Body mass index at follow-up was associated with body mass index at diagnosis (P .004) and tumor resection as an initial treatment approach (P .028). A shift in surgical treatment approach away from gross total resection has led to improved endocrine outcomes. This may have beneficial implications for quality of life in survivors.