Zhang C, et al. - Researchers evaluated patterns of care in the management of craniopharyngioma, with a special emphasis on the use of radiation therapy (RT) alone vs gross total resection (GTR) and subtotal resection (STR) with adjuvant RT. They found that management of craniopharyngioma continued to be somewhat controversial, and definitive RT, GTR, and STR+RT provided no different outcomes.

Methods

• Researchers used the Surveillance Epidemiology and End Results (SEER) database from 2004 to 2012 to study the epidemiology, treatment modalities, and outcomes of patients with craniopharyngioma.
• They used Kaplan-Meier analysis and log-rank tests to compare survival between treatment groups.

Results

• They identified 1,218 patients with craniopharyngioma; distribution was equal across sex.
• Bimodal incidence peaks were reported at 20 years old or below, and the other between 40 and 65 years.
• Adamantinomatous type was reported as the majority of pediatric tumors with known histology, which had no impact on the outcomes when adjusting for age (P=0.392).
• No statistical difference was observed in terms of overall survival/cause-specific death for patients that underwent RT, STR+RT, and GTR (P > 0.05).
• Improved survival was observed between several modalities: RT only vs STR only (P=0.024), RT only vs observation (P=0.006), STR+RT vs observation (P=0.046), and GTR vs observation (P=0.046).
• Data showed patients above 65 years old were more likely to undergo observation (P=0.002), with the highest proportions of surgery (54%)/RT (21%) in the pediatric population.
• In multivariable analysis, age was shown to be related to overall survival (P < 0.001), while treatment modality (RT/GTR/STR+RT) was not (P=0.119).