Adult Craniopharyngiomas: Long-Term Outcome after Surgical Resection

Objective: To analyze the long-term data of adults who underwent a surgical resection of a craniopharyngioma (CP). Methods: Data of adults with CP who underwent surgery between 1992 and 2011 were retrospectively collected and enrolled in a data bank. The collected data comprises: patients' history, imaging data, operative and clinical records, as well as hormonal and visual recovery. Results: We identified 48 CP adult patients, with a median age of 42 years. Most patients were preoperatively presented with visual disturbances or/and headache (68%). An affected gonadal function was the most common endocrinological failure, seen in 16 patients. Surgically, the pterional approach was most frequently performed (58.4%), followed by the transnasal-transsphenoidal approach (18.7%). A MRI confirmed complete resection was achieved in 31 patients (77.5%). Overall 12 patients underwent a second surgery due to a local recurrence with a median recurrence time of 17 months (4.6-146 months). A second recurrence was seen in four patients with a median time of 23.5 months. Postoperative complications contained: diabetes insipidus (five patients), deterioration of the visual acuity (three patients), postoperative hemorrhages in three patients and cognitive deficits in seven patients. The 5-year survival in our series is 93%. However, three patients died within the first 5 months after surgery due to severe hypothalamo-hypophyseal disturbances. Conclusion: The risk of postoperative deficits in adults CP is high.