Abstract：
OBJECTIVE: Experience with management of craniopharyngiomas (CPH) was evaluated retrospectively.
METHODS: Between 1981 and 2012, 100 patients underwent removal of a CPH (the main surgical group), and an original tumor grading system was applied to these cases. The mean length of follow-up was 121 months. Additionally, 17 patients underwent removal of a CPH between 2012 and 2017 (the supplementary surgical group), and in 6 of them, CyberKnife radiosurgery was performed on a residual tumor (in 5 cases) or at the time of recurrence (in 1 case).
RESULTS: In the main surgical group, the gross total resection (GTR) rate was 81%. The early and late disease-specific postoperative mortality rates were 0% and 2%, respectively. Tumor recurrence was never noted after GTR. There was a statistically significant increase in the Karnofsky Performance Scale (KPS) score after surgery. The tumor surgical grade was inversely associated with both the pre- and postoperative KPS scores, and was lower in cases operated on via the transnasal transsphenoidal approach, but was unrelated to the GTR rate. In the supplementary surgical group, the GTR rate was 65%. CyberKnife radiosurgery consistently resulted in tumor shrinkage.
CONCLUSIONS: GTR is the preferred management option for CPH. The original surgical grading system developed at Tokyo Women\'s Medical University may be helpful for clinical decision-making. CyberKnife radiosurgery for residual and recurrent CPH is associated with high tumor response rates.
METHODS: Between 1981 and 2012, 100 patients underwent removal of a CPH (the main surgical group), and an original tumor grading system was applied to these cases. The mean length of follow-up was 121 months. Additionally, 17 patients underwent removal of a CPH between 2012 and 2017 (the supplementary surgical group), and in 6 of them, CyberKnife radiosurgery was performed on a residual tumor (in 5 cases) or at the time of recurrence (in 1 case).
RESULTS: In the main surgical group, the gross total resection (GTR) rate was 81%. The early and late disease-specific postoperative mortality rates were 0% and 2%, respectively. Tumor recurrence was never noted after GTR. There was a statistically significant increase in the Karnofsky Performance Scale (KPS) score after surgery. The tumor surgical grade was inversely associated with both the pre- and postoperative KPS scores, and was lower in cases operated on via the transnasal transsphenoidal approach, but was unrelated to the GTR rate. In the supplementary surgical group, the GTR rate was 65%. CyberKnife radiosurgery consistently resulted in tumor shrinkage.
CONCLUSIONS: GTR is the preferred management option for CPH. The original surgical grading system developed at Tokyo Women\'s Medical University may be helpful for clinical decision-making. CyberKnife radiosurgery for residual and recurrent CPH is associated with high tumor response rates.
摘要：
目的：回顾性评估颅咽管瘤（CPH）的治疗经验。
方法：在1981年至2012年之间，100例患者接受了CPH的摘除（主要手术组），并对这些病例应用了原始的肿瘤分级系统。平均随访时间为121个月。此外,2012年至2017年期间，17例患者接受了CPH的切除（补充手术组），其中6个，对残留肿瘤（5例）或复发时（1例）进行了射波刀放射外科手术。
结果：在主要手术组中，总切除率(GTR)为81%.术后早期和晚期疾病特异性死亡率分别为0%和2%,分别。GTR后从未发现肿瘤复发。手术后Karnofsky性能量表（KPS）评分有统计学上的显着增加。肿瘤手术分级与术前和术后KPS评分呈负相关，通过经鼻蝶入路手术的病例较低，但与GTR率无关。在辅助手术组中，GTR率为65%。射波刀放射外科手术始终导致肿瘤缩小。
结论：GTR是CPH的首选管理选择。东京女子医科大学开发的原始手术分级系统可能有助于临床决策。射波刀治疗残留和复发的CPH与高肿瘤反应率相关。
方法：在1981年至2012年之间，100例患者接受了CPH的摘除（主要手术组），并对这些病例应用了原始的肿瘤分级系统。平均随访时间为121个月。此外,2012年至2017年期间，17例患者接受了CPH的切除（补充手术组），其中6个，对残留肿瘤（5例）或复发时（1例）进行了射波刀放射外科手术。
结果：在主要手术组中，总切除率(GTR)为81%.术后早期和晚期疾病特异性死亡率分别为0%和2%,分别。GTR后从未发现肿瘤复发。手术后Karnofsky性能量表（KPS）评分有统计学上的显着增加。肿瘤手术分级与术前和术后KPS评分呈负相关，通过经鼻蝶入路手术的病例较低，但与GTR率无关。在辅助手术组中，GTR率为65%。射波刀放射外科手术始终导致肿瘤缩小。
结论：GTR是CPH的首选管理选择。东京女子医科大学开发的原始手术分级系统可能有助于临床决策。射波刀治疗残留和复发的CPH与高肿瘤反应率相关。
