Background and Aim: Craniopharyngiomas (CP) are histologically benign tumors of the sellarsuprasellar region and are associated with significant morbidity. Due to the lack of knowledge of the factors responsible for the recurrence of CP and the challenges in surgeries for recurrent CP studies, it is necessary to determine the predictive factors for CP patients for preoperative prognosis and also for proper planning of surgery for a better functional outcome. Using”primum non nocere” or “do no harm” rule, our study tries to find out the optimum surgical strategy to have a better functional outcome as well as to reduce recurrence.
Methods and Materials/Patients: This study is a 5-year retrospective analysis of the institutes of neuropathology database and clinical and radiological data with 12 months of follow-up in such patients.
Results: Out of 72 patients, 33 were men and 39 were women with a mean age of 17.34 years. A total of 11 patients underwent gross total resection (GTR) and the rest 61 patients were operated by subtotal resection (STR) followed by radiotherapy (RT). The recurrence rate in GTR and STR+radiotherapy (RT)was 1% and 24%, respectively. Eighteen cases had a poor postoperative outcome with a mortality rate of 6.98. Postoperative visual loss, obesity, neurological deficit, and diabetes insipidus (DI) were more common in the GTR group, while postoperative endocrinal dysfunction was more common in the STR+RT group. Also, older age, preoperative vision loss, hypothalamus invasion, and GTR were associated with poor postoperative outcomes.
Conclusion: Patient-tailored resection should be performed for better functional outcomes with acceptable recurrence rates. Preoperative risk factor analysis helps to make proper surgical decisions regarding the extent of resection.