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Child's Nervous System

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01-05-2021 | Craniopharyngioma | Original Article

Characteristics and overall survival in pediatric versus adult craniopharyngioma: a population-based study

Authors: Brandon M. Lehrich, Khodayar Goshtasbi, Frank P. K. Hsu, Edward C. Kuan

Published in: Child's Nervous System | Issue 5/2021

Abstract

Purpose

This study uses a large-population national database to describe the presenting clinical, sociodemographic, treatment, and clinical outcome differences between pediatric and adult craniopharyngiomas.

Methods

This study utilized the 2004–2015 National Cancer Database and was queried for all cases of craniopharyngioma. Multivariate Cox proportional-hazards analysis was used to determine clinical and sociodemographic factors associated with mortality. Kaplan-Meier log-rank test determined differences in overall survival (OS) time.

Results

The cohort consisted of 3638 patients, with 816 (22.4%) pediatric (≤ 18 years) patients. Pediatric patients presented with significantly higher frequency of large tumors (> 3 cm, 54.1 vs. 31.8%, p < 0.001), lower frequency of papillary subtype (0.9 vs. 11.5%, p < 0.001), and were exclusively treated at academic centers (100 vs. 73.4%, p < 0.001). Pediatric patients had significantly higher rates of adjuvant radiation (34.3 vs. 22.3%; p < 0.001), and had significantly lower 90-day mortality (1.6 vs. 4.9%; p < 0.001); however, no significant differences in extent of resection (p = 0.93), length of hospital stay (p = 0.53), and 30-day readmissions (p = 0.06) were observed between pediatric and adult patients. On Kaplan-Meier log-rank test, there were no significant differences in OS in pediatric patients receiving gross total resection (GTR), subtotal resection (STR), or STR + adjuvant radiation (p = 0.68). Lastly, when comparing endoscopic and open surgical approaches in pediatric patients, there were no significant differences in extent of surgical resection (p = 0.81), length of hospital stay (p = 0.54), 30-day readmissions (p = 0.22), and 90-day mortality (p = 0.80).

Conclusion

Craniopharyngioma has improved OS in pediatric compared to adult patients. Pediatric craniopharyngioma patients are best managed within multidisciplinary teams at academic centers with an individualized approach.

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Title: Characteristics and overall survival in pediatric versus adult craniopharyngioma: a population-based study
Authors: Brandon M. Lehrich
Khodayar Goshtasbi
Frank P. K. Hsu
Edward C. Kuan
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Keyword: Craniopharyngioma
Published in: Child's Nervous System / Issue 5/2021
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-021-05094-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Characteristics and overall survival in pediatric versus adult craniopharyngioma: a population-based study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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