Skip to main content
SpringerLink
Log in

Patterns of care and treatment outcomes of patients with Craniopharyngioma in the national cancer database

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

To investigate the patterns of care and outcomes in patients with craniopharyngioma in the National Cancer Data Base (NCDB). This study included 697 patients (166 pediatric and 531 adult cases) treated for craniopharyngioma between 2004 and 2012 in the NCDB. Adjuvant radiotherapy (RT) was defined if within 6 months of surgery. Limited surgery (LS) was defined as biopsy or subtotal resection. Proportional-hazards models were used to evaluate associations between covariates and overall survival (OS). A time-dependent analysis of RT was performed to account for early deaths after surgery. Median follow-up was 46 months. Overall, 21% of patients received adjuvant RT. Of patients with known surgical extent (n = 195), 71% had LS. Utilization of adjuvant RT increased from 18% in 2004–2007 to 24% in 2008–2012. Patterns of care regarding adjuvant RT or LS were not significantly different between adult and pediatric patients. Tumor size, low comorbidity, and LS were associated with increased utilization of adjuvant RT. The 5-year OS among patients treated with LS, LS+RT, and gross total resection were 75, 85, and 82% (p = 0.02). On multivariate analysis of the 195 patients with known surgical extent, LS+RT was associated with improved OS compared to LS (HR 0.22, 95% CI 0.05–0.99, p = 0.04), but was not significant when early deaths (<2 months from surgery) were removed to adjust for immortal-time bias. Medical practice regarding surgical approach and adjuvant RT are similar for pediatric and adult craniopharyngiomas. Immortal-time bias may confound assessment of OS for adjuvant RT. Prospective studies comparing adjuvant RT versus observation after LS are warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Jane JA, Laws ER (2006) Craniopharyngioma. Pituitary 9:323–326. doi:10.1007/s11102-006-0413-8

    Article  PubMed  Google Scholar 

  2. Bunin GR, Surawicz TS, Witman PA et al (1998) The descriptive epidemiology of craniopharyngioma. J Neurosurg 89:547–551. doi:10.3171/jns.1998.89.4.0547

    Article  CAS  PubMed  Google Scholar 

  3. Poretti A, Grotzer M a, Ribi K et al (2004) Outcome of craniopharyngioma in children: long-term complications and quality of life. Dev Med Child Neurol 46:220–229. doi:10.1017/S0012162204000374

    Article  PubMed  Google Scholar 

  4. Cohen M, Bartels U, Branson H et al (2013) Trends in treatment and outcomes of pediatric craniopharyngioma, 1975–2011. Neuro Oncol 15:767–774

    Article  PubMed  PubMed Central  Google Scholar 

  5. Van Effenterre R, Boch A-L (2002) Craniopharyngioma in adults and children: a study of 122 surgical cases. J Neurosurg 97:3–11. doi:10.3171/jns.2002.97.1.0003

    Article  PubMed  Google Scholar 

  6. Kalapurakal JA, Goldman S, Hsieh YC et al (2003) Clinical outcome in children with craniopharyngioma treated with primary surgery and radiotherapy deferred until relapse. Med Pediatr Oncol 40:214–218. doi:10.1002/mpo.10247

    Article  PubMed  Google Scholar 

  7. Clark AJ, Cage TA, Aranda D et al (2013) A systematic review of the results of surgery and radiotherapy on tumor control for pediatric craniopharyngioma. Childs Nerv Syst 29:231–238. doi:10.1007/s00381-012-1926-2

    Article  PubMed  Google Scholar 

  8. Hoffmann A, Warmth-Metz M, Gebhardt U, et al (2014) Childhood craniopharyngioma - changes of treatment strategies in the trials KRANIOPHARYNGEOM 2000/2007. Klin Pädiatrie 226:161–168. doi:10.1055/s-0034-1368785

    Article  CAS  Google Scholar 

  9. Stripp DCH, Maity A, Janss AJ et al (2004) Surgery with or without radiation therapy in the management of craniopharyngiomas in children and young adults. Int J Radiat Oncol Biol Phys 58:714–720. doi:10.1016/S0360-3016(03)01570-0

    Article  PubMed  Google Scholar 

  10. Schoenfeld A, Pekmezci M, Barnes MJ et al (2012) The superiority of conservative resection and adjuvant radiation for craniopharyngiomas. J Neurooncol 108:133–139. doi:10.1007/s11060-012-0806-7

    Article  PubMed  Google Scholar 

  11. Merchant TE, Kiehna EN, Sanford RA et al (2002) Craniopharyngioma: the St. Jude children’s research hospital experience 1984–2001. Int J Radiat Oncol Biol Phys 53:533–542

    Article  PubMed  Google Scholar 

  12. Yang I, Sughrue ME, Rutkowski MJ et al (2010) Craniopharyngioma: a comparison of tumor control with various treatment strategies. Neurosurg Focus 28:E5

    Article  PubMed  Google Scholar 

  13. Lin LL, El Naqa I, Leonard JR et al (2008) Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatr 1:126–130. doi:10.3171/PED/2008/1/2/126

    Article  PubMed  Google Scholar 

  14. Combs SE, Thilmann C, Huber PE et al (2007) Achievement of long-term local control in patients with craniopharyngiomas using high precision stereotactic radiotherapy. Cancer 109:2308–2314. doi:10.1002/cncr.22703

    Article  PubMed  Google Scholar 

  15. Pemberton LS, Dougal M, Magee B, Gattamaneni HR (2005) Experience of external beam radiotherapy given adjuvantly or at relapse following surgery for craniopharyngioma. Radiother Oncol 77:99–104. doi:10.1016/j.radonc.2005.04.015

    Article  PubMed  Google Scholar 

  16. Hankinson TC, Palmeri NO, Williams SA et al (2013) Patterns of care for craniopharyngioma: survey of members of the American Association of Neurological Surgeons. Pediatr Neurosurg 49:131–136. doi:10.1159/000357783

    Article  PubMed  Google Scholar 

  17. Deyo RA, Cherkin DC, Ciol MA (1992) Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 45:613–619

    Article  CAS  PubMed  Google Scholar 

  18. Zacharia BE, Bruce SS, Goldstein H et al (2012) Incidence, treatment and survival of patients with craniopharyngioma in the surveillance, epidemiology and end results program. Neuro Oncol 14:1070–1078

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hankinson TC, Fields EC, Torok MR et al (2012) Limited utility despite accuracy of the national SEER dataset for the study of craniopharyngioma. J Neurooncol 110:271–278. doi:10.1007/s11060-012-0966-5

    Article  PubMed  Google Scholar 

  20. Yaşargil MG, Curcic M, Kis M et al (1990) Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients. J Neurosurg 73:3–11

    Article  PubMed  Google Scholar 

  21. Sainte-Rose C, Puget S, Wray A et al (2005) Craniopharyngioma: The pendulum of surgical management. Child’s Nerv Syst 21:691–695

    Article  Google Scholar 

  22. Hayward R (1999) The present and future management of childhood craniopharyngioma. Child Nerv Syst 15:764–769. doi:10.1007/s003810050468

    Article  CAS  Google Scholar 

  23. Kiehna EN, Merchant TE (2010) Radiation therapy for pediatric craniopharyngioma. Neurosurg Focus 28:E10

    Article  PubMed  Google Scholar 

  24. Zoicas F, Schöfl C (2012) Craniopharyngioma in adults. Front. Endocrinol. (Lausanne). 3

  25. Rajan B, Ashley S, Gorman C et al (1993) Craniopharyngioma–a long-term results following limited surgery and radiotherapy. Radiother Oncol 26:1–10

    Article  CAS  PubMed  Google Scholar 

  26. Habrand JL, Ganry O, Couanet D et al (1999) The role of radiation therapy in the management of craniopharyngioma: a 25-year experience and review of the literature. Int J Radiat Oncol Biol Phys 44:255–263

    Article  CAS  PubMed  Google Scholar 

  27. Regine WF, Kramer S (1992) Pediatric craniopharyngiomas: Long term results of combined treatment with surgery and radiation. Int J Radiat Oncol 24:611–617. doi:10.1016/0360-3016(92)90705-M

    Article  CAS  Google Scholar 

  28. Hetelekidis S, Barnes PD, Tao ML et al (1993) 20-Year experience in childhood craniopharyngioma. Int J Radiat Oncol Biol Phys 27:189–195

    Article  CAS  PubMed  Google Scholar 

  29. Aggarwal A, Fersht N, Brada M (2013) Radiotherapy for craniopharyngioma. Pituitary 16:26–33

    Article  PubMed  Google Scholar 

  30. Müller HL, Gebhardt U, Schröder S, et al (2010) Analyses of treatment variables for patients with childhood craniopharyngioma–results of the multicenter prospective trial KRANIOPHARYNGEOM 2000 after three years of follow-up. Horm Res Paediatri 73:175–180. doi:10.1159/000284358

    Article  Google Scholar 

  31. Muller HL (2008) Childhood craniopharyngioma. Recent advances in diagnosis, treatment and follow-up. Horm Res 69:193–202. doi:10.1159/000113019

    PubMed  Google Scholar 

  32. Muller HL KRANIOPHARYNGEOM 2007: Multicenter prospective study of children and adolescents with craniopharyngioma. http://www.kinderkrebsinfo.de/sites/kinderkrebsinfo/content/e1676/e9032/e1758/e28472/download67843/KRANIOPHARYNGEOM2007_english_3._ger.pdf.

Download references

Acknowledgements

The Authors wish to acknowledge the Commission on Cancer of the American College of Surgeons and the American Cancer Society for making public data available through the National Cancer Data Base (NCDB). The NCDB is a joint project of the Commission on Cancer (CoC) of the American College of Surgeons and the American Cancer Society. The CoC’s NCDB and the hospitals participating in the CoC NCDB are the source of the de-identified data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

Funding

None.

Author information

Author notes

    Authors and Affiliations

    1. Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Campus Box 8224, St. Louis, MO, 63110, USA

      Yuan J. Rao, Benjamin Fischer-Valuck, Stephanie M. Perkins & Jiayi Huang

    2. Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, 63110, USA

      Michael R. Chicoine & Albert H. Kim

    3. University of Missouri–Kansas City School of Medicine, Kansas City, MO, 64108, USA

      Comron Hassanzadeh

    Authors
    1. Yuan J. Rao
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Comron Hassanzadeh
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Benjamin Fischer-Valuck
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Michael R. Chicoine
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Albert H. Kim
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Stephanie M. Perkins
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Jiayi Huang
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Jiayi Huang.

    Ethics declarations

    Conflict of interest

    The authors report no conflicts of interest.

    Ethical approval

    This article does not contain any studies with human participants or animals performed by any of the authors.

    Additional information

    Yuan James Rao and Comron Hassanzadeh have contributed equally to the work.

    Electronic supplementary material

    Below is the link to the electronic supplementary material.

    Supplementary material 1 (DOCX 26 KB)

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Rao, Y.J., Hassanzadeh, C., Fischer-Valuck, B. et al. Patterns of care and treatment outcomes of patients with Craniopharyngioma in the national cancer database. J Neurooncol 132, 109–117 (2017). https://doi.org/10.1007/s11060-016-2342-3

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s11060-016-2342-3

    Keywords

    Search

    Navigation