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Acta Neurochirurgica

Erschienen in:

01.12.2024 | Review Article

The role of endoscopic endonasal salvage surgery in recurrent or residual craniopharyngioma after a transcranial approach: a systematic review

verfasst von: Gurkirat Kohli, Phabinly J. Gabriel, Melanie Brady, Christina H. Fang, Jean Anderson Eloy, James K. Liu

Erschienen in: Acta Neurochirurgica | Ausgabe 1/2024

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Abstract

Background

The management of craniopharyngiomas is challenging due to their high rate of recurrence following resection. Excision of recurrent tumors poses further surgical challenges due to loss of arachnoidal planes and adherence to anatomical structures. The endoscopic endonasal approach (EEA) offers a favorable alternative to transcranial approaches for primary craniopharyngiomas. However, the safety and efficacy of EEA for recurrent tumors, specifically after a prior transcranial approach, needs further investigation.

Methods

We performed a systematic review using PubMed to develop a database of cases of recurrent craniopharyngiomas previously treated with a transcranial approach.

Results

Fifteen articles were included in this review with a total of 75 cases. There were 50 males and 25 females with a mean age of 38 years (range 2–80). One prior transcranial surgery was done in 80.0% of cases, while 8.0% had two and 12.0% had more than two prior surgeries. Radiotherapy after transcranial resection was given in 18 cases (24.0%). Following EEA, vision improved in 60.0% of cases, and vision worsened in 8.6% of the cases. Of cases, 64.4% had pre-existing anterior hypopituitarism, and 43.8% had diabetes insipidus prior to EEA. New anterior hypopituitarism and diabetes insipidus developed in 24.6% and 21.9% of cases, respectively following EEA. Gross total resection (GTR) was achieved in 64.0%, subtotal resection in 32.0%, and partial resection in 4.0% revision EEA cases. GTR rate was higher in cases with no prior radiotherapy compared to cases with prior radiotherapy (72.0% vs 39.0%, p = 0.0372). The recurrence rate was 17.5% overall but was significantly lower at 10.0% following GTR (p = 0.0019). The average follow-up length was 41.2 months (range, 1–182 months).

Conclusion

The EEA can be utilized for resection of recurrent or residual craniopharyngiomas previously managed by a transcranial approach.

Alalade AF, Ogando-Rivas E, Boatey J, Souweidane MM, Anand VK, Greenfield JP, Schwartz TH (2018) Suprasellar and recurrent pediatric craniopharyngiomas: expanding indications for the extended endoscopic transsphenoidal approach. J Neurosurg Pediatr 21:72–80CrossRefPubMed

Alli S, Isik S, Rutka JT (2016) Microsurgical removal of craniopharyngioma: endoscopic and transcranial techniques for complication avoidance. J Neurooncol 130:299–307CrossRefPubMed

Bal E, Oge K, Berker M (2016) Endoscopic endonasal transsphenoidal surgery, a reliable method for treating primary and recurrent/residual craniopharyngiomas: nine years of experience. World Neurosurg 94:375–385CrossRefPubMed

Borg A, Kirkman MA, Choi D (2016) Endoscopic endonasal anterior skull base surgery: a systematic review of complications during the past 65 years. World Neurosurg 95:383–391CrossRefPubMed

Brastianos PK, Twohy E, Geyer S, Gerstner ER, Kaufmann TJ, Tabrizi S, Kabat B, Thierauf J, Ruff MW, Bota DA, Reardon DA, Cohen AL, De La Fuente MI, Lesser GJ, Campian J, Agarwalla PK, Kumthekar P, Mann B, Vora S, Knopp M, Iafrate AJ, Curry WT Jr, Cahill DP, Shih HA, Brown PD, Santagata S, Barker FG 2nd, Galanis E (2023) BRAF-MEK inhibition in newly diagnosed papillary craniopharyngiomas. N Engl J Med 389(2):118–126

Caldarelli M, di Rocco C, Papacci F, Colosimo CJ (1998) Management of recurrent craniopharyngioma Acta Neurochir (Wien) 140:447–454CrossRefPubMed

Campbell PG, McGettigan B, Luginbuhl A, Yadla S, Rosen M, Evans JJ (2010) Endocrinological and ophthalmological consequences of an initial endonasal endoscopic approach for resection of craniopharyngiomas. Neurosurg Focus 28:E8CrossRefPubMed

Cavallo LM, Prevedello DM, Solari D, Gardner PA, Esposito F, Snyderman CH, Carrau RL, Kassam AB, Cappabianca P (2009) Extended endoscopic endonasal transsphenoidal approach for residual or recurrentcraniopharyngiomas. J Neurosurg 111:578–589CrossRefPubMed

Cavallo LM, Frank G, Cappabianca P, Solari D, Mazzatenta D, Villa A, Zoli M, D’Enza AI, Esposito F, Pasquini E (2014) The endoscopic endonasal approach for the management of craniopharyngiomas: a series of 103 patients. J Neurosurg 121:100–113CrossRefPubMed

10.

Cavallo LM, Solari D, Esposito F, Cappabianca P (2013) The endoscopic endonasal approach for the management of craniopharyngiomas involving the third ventricle. Neurosurg Rev 36:27–37CrossRefPubMed

11.

Cavallo LM, Solari D, Esposito F, Villa A, Minniti G, Cappabianca P (2014) The role of the endoscopic endonasal route in the management of craniopharyngiomas. World Neurosurg 82:S32–40CrossRefPubMed

12.

de Divitiis E, Cavallo LM, Cappabianca P, Esposito F (2007) Extended endoscopic endonasal transsphenoidal approach for the removal of suprasellar tumors: part 2. Neurosurgery 60:46–49CrossRefPubMed

13.

Dehdashti AR, Ganna A, Witterick I, Gentili F (2009) Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations. Neurosurgery 64:677–679CrossRefPubMed

14.

Dhandapani S, Singh H, Negm HM, Cohen S, Souweidane MM, Greenfield JP, Anand VK, Schwartz TH (2017) Endonasal endoscopic reoperation for residual or recurrent craniopharyngiomas. J Neurosurg 126:418–430CrossRefPubMed

15.

Elliott RE, Hsieh K, Hochm T, Belitskaya-Levy I, Wisoff J, Wisoff JH (2010) Efficacy and safety of radical resection of primary and recurrent craniopharyngiomas in 86 children. J Neurosurg Pediatr 5:30–48CrossRefPubMed

16.

Fahlbusch R, Honegger J, Paulus W, Huk W, Buchfelder M (1999) Surgical treatment of craniopharyngiomas: experience with 168 patients. J Neurosurg 90:237–250CrossRefPubMed

17.

Frank G, Pasquini E, Doglietto F, Mazzatenta D, Sciarretta V, Farneti G, Calbucci F (2006) The endoscopic extended transsphenoidal approach for craniopharyngiomas. Neurosurgery 59:ONS75–83; discussion ONS75–83 .

18.

Gardner PA, Kassam AB, Snyderman CH, Carrau RL, Mintz AH, Grahovac S, Stefko S (2008) Outcomes following endoscopic, expanded endonasal resection of suprasellar craniopharyngiomas: a case series. J Neurosurg 109:6–16CrossRefPubMed

19.

Jane JAJ, Prevedello DM, Alden TD, Laws ERJ (2010) The transsphenoidal resection of pediatric craniopharyngiomas: a case series. J Neurosurg Pediatr 5:49–60CrossRefPubMed

20.

Jane JAJ, Kiehna E, Payne SC, Early SV, Laws ERJ (2010) Early outcomes of endoscopic transsphenoidal surgery for adult craniopharyngiomas. Neurosurg Focus 28:E9CrossRefPubMed

21.

Kassam AB, Gardner PA, Snyderman CH, Carrau RL, Mintz AH, Prevedello DM (2008) Expanded endonasal approach, a fully endoscopic transnasal approach for the resection of midline suprasellar craniopharyngiomas: a new classification based on the infundibulum. J Neurosurg 108:715–728CrossRefPubMed

22.

Kassam AB, Prevedello DM, Carrau RL, Snyderman CH, Thomas A, Gardner P, Zanation A, Duz B, Stefko ST, Byers K, Horowitz MB (2011) Endoscopic endonasal skull base surgery: analysis of complications in the authors’ initial 800 patients. J Neurosurg 114:1544–1568CrossRefPubMed

23.

Kim SK, Kim YH, Park C-K, Kim DG, Jung H-W (2014) Extended endoscopic endonasal approach for recurrent or residual adult craniopharyngiomas. Acta Neurochir (Wien) 156:1917–1922CrossRefPubMed

24.

Kitano M, Taneda M (2009) Extended transsphenoidal surgery for suprasellar craniopharyngiomas: infrachiasmatic radical resection combined with or without a suprachiasmatic trans-lamina terminalis approach. Surg Neurol 71:290–298CrossRefPubMed

25.

Komotar RJ, Starke RM, Raper DMS, Anand VK, Schwartz TH (2012) Endoscopic endonasal compared with microscopic transsphenoidal and open transcranial resection of craniopharyngiomas. World Neurosurg 77:329–341CrossRefPubMed

26.

Koutourousiou M, Gardner PA, Fernandez-Miranda JC, Tyler-Kabara EC, Wang EW, Snyderman CH (2013) Endoscopic endonasal surgery for craniopharyngiomas: surgical outcome in 64 patients. J Neurosurg 119:1194–1207CrossRefPubMed

27.

Lania A, Spada A, Lasio G (2016) Diagnosis and Management of Craniopharyngiomas: Key current topics. Springer International Publishing

28.

Lara-Velazquez M, Mehkri Y, Panther E, Hernandez J, Rao D, Fiester P, Makary R, Rutenberg M, Tavanaiepour D, Rahmathulla G (2022) Current advances in the management of adult craniopharyngiomas. Current Oncology (Toronto Ont) 29(3):1645–1671

29.

Leng LZ, Greenfield JP, Souweidane MM, Anand VK, Schwartz TH (2012) Endoscopic, endonasal resection of craniopharyngiomas: analysis of outcome including extent of resection, cerebrospinal fluid leak, return to preoperative productivity, and body mass index. Neurosurgery 70:110–114CrossRefPubMed

30.

Liu JK, Sevak IA, Carmel PW, Eloy JA (2016) Microscopic versus endoscopic approaches for craniopharyngiomas: choosing the optimal surgical corridor for maximizing extent of resection and complication avoidance using a personalized, tailored approach. Neurosurg Focus 41:E5CrossRefPubMed

31.

Liubinas SV, Munshey AS, Kaye AH (2011) Management of recurrent craniopharyngioma. J Clin Neurosci Off J Neurosurg Soc Australas 18:451–457

32.

Minamida Y, Mikami T, Hashi K, Houkin K (2005) Surgical management of the recurrence and regrowth of craniopharyngiomas. J Neurosurg 103:224–232CrossRefPubMed

33.

Mortini P, Gagliardi F, Bailo M, Losa M (2016) Surgical approach to craniopharyngiomas: transcranial routes. In: Lania A, Spada A, Lasio G (eds) Diagnosis and Management of Craniopharyngiomas. Springer, Cham

34.

Müller HL (2014) Craniopharyngioma. Endocr Rev 35:513–543CrossRefPubMed

35.

Park C-S, Kim B-G, Shin J-H, Cho J-H (2014) Endoscopic transnasal transsphenoidal approach for craniopharyngioma: report of 6 cases. Ear Nose Throat J 93:E16-20PubMed

36.

Rubin BA, Kim I, Wisoff JH (2015) Management of the recurrence of craniopharyngiomas. In: Kenning TJ, Evans JJBT-C (eds) Academic press, Boston, pp 419–425

37.

Savateev AN, Trunin YY, Mazerkina NA (2017) Radiotherapy and radiosurgery in treatment of craniopharyngiomas. Zh Vopr Neirokhir Im N N Burdenko 81:94–106CrossRefPubMed

38.

Schoenfeld A, Pekmezci M, Barnes MJ, Tihan T, Gupta N, Lamborn KR, Banerjee A, Mueller S, Chang S, Berger MS, Haas-Kogan D (2012) The superiority of conservative resection and adjuvant radiation for craniopharyngiomas. J Neuro-Oncol 108(1):133–139CrossRef

39.

Tang B, Xiao L, Xie S, Huang G, Wang Z, Zhou D, Zeng E, Hong T (2018) Extended endoscopic endonasal approach for recurrent or residual symptomatic craniopharyngiomas. Clin Neurol Neurosurg 168:38–45CrossRefPubMed

40.

Turel MK, Tsermoulas G, Gonen L, Klironomos G, Almeida JP, Zadeh G, Gentili F (2016) Management and outcome of recurrent adult craniopharyngiomas: an analysis of 42 cases with long-term follow-up. Neurosurg Focus 41:E11CrossRefPubMed

41.

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

42.

Zuccaro G (2005) Radical resection of craniopharyngioma. Childs Nerv Syst 21:679–690CrossRefPubMed

Titel: The role of endoscopic endonasal salvage surgery in recurrent or residual craniopharyngioma after a transcranial approach: a systematic review
verfasst von: Gurkirat Kohli
Phabinly J. Gabriel
Melanie Brady
Christina H. Fang
Jean Anderson Eloy
James K. Liu
Publikationsdatum: 01.12.2024
Verlag: Springer Vienna
Erschienen in: Acta Neurochirurgica / Ausgabe 1/2024
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-024-05980-9

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Background

Methods

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