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Recurrence rates after neuroendoscopic fenestration and Gamma Knife surgery in comparison with subtotal resection and Gamma Knife surgery for the treatment of cystic craniopharyngiomas.

Authors
 Young Seok Park ; Jong Hee Chang ; Dong-Seok Kim ; Yong Gou Park 
Citation
 Journal of Neurosurgery, Vol.114(5) : 1360-1368, 2011 
Journal Title
 Journal of Neurosurgery 
ISSN
 0022-3085 
Issue Date
2011
Abstract
OBJECT: The object of this study was to compare the recurrence rates of cystic craniopharyngiomas after neuroendoscopic cyst fenestration combined with Gamma Knife surgery (GKS) and after subtotal resection (STR) combined with GKS. METHODS: The records of 27 patients (age range 3-66 years) with cystic craniopharyngiomas that were treated surgically or neuroendoscopically before GKS between January 2000 and December 2007 were reviewed to compare recurrence rates. The patients were divided into 2 groups: Group 1 (13 patients) received the neuroendoscopic procedure before GKS, and Group 2 (14 patients) received an STR followed by GKS. Tumor volumes, radiation doses, visual field defects, endocrine levels, and recurrences were compared between the 2 groups. Patients with solid tumors and those who underwent complete resection were excluded from the study. RESULTS: The recurrence rate for Group 1 was higher than that of Group 2 (p = 0.046). The radiation dose near the optic chiasm was higher in Group 1 (p = 0.021) than in Group 2. However, endocrine function was better preserved in Group 1 than in Group 2. CONCLUSIONS: This investigation confirms that STR followed by GKS results in a lower recurrence rate than neuroendoscopy and GKS. Neuroendoscopy and GKS, however, results in a better preservation of endocrine function. These results suggest that a generalized multimodal approach including endoscopic fenestration in addition to GKS is hindered by higher recurrence rates.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/93024
DOI
10.3171/2009.9.JNS09301.
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Neurosurgery
Yonsei Authors
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Link
 http://thejns.org/doi/full/10.3171/2009.9.JNS09301
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