Longitudinal analysis of visual outcomes after surgical treatment of adult craniopharyngiomas.

Abstract

BACKGROUND:

Craniopharyngiomas (CRPs) often cause visual deterioration (VD) due to the close vicinity of the optic apparatus.

OBJECTIVE:

To evaluate longitudinal visual outcomes after surgery of CRP and determine the prognostic factors thereof.

METHODS:

One hundred forty-six adult patients who underwent surgery for newly diagnosed CRP were retrospectively reviewed. There were 87 male patients (60%), and the median age was 41 years (range, 18-75). The mean follow-up duration was 88.7 months (range, 24-307). A visual impairment score was used to assess the short-term (<1 month) and long-term (>2 years) visual outcomes.

RESULTS:

Gross total removal was performed in 53 patients (36%), and tumor recurrence occurred in 40 patients (27%). The average preoperative, short- and long-term visual impairment scores were 44.4, 38.5, and 38.1, respectively, on a 0- to 100-point scale (with 100 indicating the worst vision). Short- and long-term VD occurred in 28 (19%) and 39 patients (27%), respectively. Subtotal removal (STR) alone (P = .010; OR = 4.8), short-term VD (P < .001; OR = 39.7), and tumor recurrence (P < .001; OR = 28.2) were significant risk factors for long-term VD in the multivariate analysis. Patients undergoing STR alone had higher tumor recurrence rates in comparison with those who underwent gross total removal or STR with adjuvant therapy (P < .001).

CONCLUSION:

Short-term VD secondary to the surgical insult and the recurrence of the tumor were strong predictors of long-term visual outcomes after surgical treatment for CRP. STR alone may be an ineffective strategy for achieving tumor control and optimal visual outcomes in patients with CRP.

• Authors: Young-Hoon Kim, Chae-Yong Kim, Jin Wook Kim, Yong Hwy Kim, Jung Ho Han, Chul-Kee Park, Sun Ha Paek, Chang Wan Oh, Dong Gyu Kim, Hee-Won Jung
• Journal: Neurosurgery (Neurosurgery) Vol. 71 Issue 3 Pg. 715-21 (Sep 2012) ISSN: 1524-4040 [Electronic] United States
• PMID: 22668887 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Craniopharyngioma (complications, surgery)
• Female
• Humans
• Male
• Middle Aged
• Pituitary Neoplasms (complications, surgery)
• Prognosis
• Retrospective Studies
• Risk Factors
• Treatment Outcome
• Vision Disorders (epidemiology, etiology)
• Young Adult