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J Neurol Surg B Skull Base
DOI: 10.1055/a-2646-2339
Original Article

Early Findings from the Multicenter RAPID Consortium on Papillary Craniopharyngiomas

Michael P. Catalino
1   Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, United States
2   Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, Virginia, United States
,
Duy Pham
1   Department of Neurosurgery, University of Virginia, Charlottesville, Virginia, United States
,
Robert C. Rennert
3   Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States
,
William T. Couldwell 
3   Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, United States
,
James J Evans
4   Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Calen Callopy
4   Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Won Kim
5   Department of Neurosurgery, University of California – Los Angeles, Los Angeles, California, United States
,
Donato Pacione
6   Department of Neurosurgery, New York University Langone Medical Center, New York, New York, United States
,
Carter M. Suryadevara
6   Department of Neurosurgery, New York University Langone Medical Center, New York, New York, United States
,
Albert Kim
7   Department of Neurosurgery, Washington University School of Medicine in Saint Louis, St. Louis, Missouri, United States
,
Julie Silverstein
7   Department of Neurosurgery, Washington University School of Medicine in Saint Louis, St. Louis, Missouri, United States
8   Division of Endocrinology, Metabolism, and Lipid Research, Washington University School of Medicine in Saint Louis, St. Louis, Missouri, United States
,
Michael Chicoine 
9   Department of Neurosurgery, University of Missouri, Columbia, Missouri, United States
,
Paul A. Gardner
10   Department of Neurosurgery, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, United States
,
Garni Barkhoudarian
11   Department of Neurosurgery, Pacific Neuroscience Institute, Los Angeles, California, United States
,
Juan C. Fernandez Miranda
12   Department of Neurosurgery, Stanford University, Palo Alto, California, United States
,
Carolina Benjamin
13   Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, United States
,
Varun R. Kshettry 
14   Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, United States
,
Gabriel Zada
15   Department of Neurosurgery, University of Southern California, Los Angeles, California, United States
,
Jamie J. Van Gompel 
16   Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States
,
Sandhya R. Palit
16   Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States
,
Nathan Zwagerman
17   Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
,
Stephanie Cheok
17   Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
,
Daniel Prevedello
18   Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
,
Kyle C. Wu
18   Department of Neurosurgery, The Ohio State University, Columbus, Ohio, United States
,
Adam Mamelak
19   Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, United States
,
Mark Pacult
20   Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States
,
Andrew Little
20   Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States
,
Michael Karsy
21   Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, United States
› Institutsangaben
Funding Information The authors acknowledge the Lodestar Foundation and Barrow Neurological Foundation for financial support.
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Abstract

Background

Craniopharyngiomas are rare parasellar tumors, and papillary craniopharyngiomas (PCPs) represent 8 to 20% of cases.

Design

Interim analysis of retrospective data collected from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID).

Setting

Fourteen U.S.-based academic skull base centers between 2011 and 2023.

Participants

Patients with PCPs.

Main Outcome Measures

Demographic, imaging, surgical, and outcome variables.

Results

Ninety-nine patients with PCPs were included. The mean age was 51.8 ± 14.7, and 57.6% were male. Most tumors showed mixed cystic/solid components (67.5%), were transinfundibular (50.0%), and were treated with an endoscopic endonasal approach (74.5%), with 51.1% demonstrating gross total resection (GTR). Pituitary stalk was preserved in 51.9%. Permanent arginine vasopressin deficiency was seen in 67.1% and was associated with pituitary stalk sacrifice (p = 0.003). Cerebrospinal fluid leak was the most common nonendocrine postsurgical, 30-day complication (9.1%), reason for return to the operating room (3.1%), and reason for 90-day readmission (8.1%). Most patients (63.9%) received no adjuvant therapy; GTR was associated with decreased radiotherapy use (p = 0.0001). BRAFV600E mutation was detected in 64/69 tumors tested, although only one patient was treated with a BRAF inhibitor. A mean follow-up of 12.3 ± 14.6 months was seen for the group.

Conclusions

RAPID consortium enabled the largest real-world clinical information dataset for PCPs. Early findings support that GTR and stalk preservation are important to outcomes. Iterative analysis and discussion of data led to the generation of a framework for future studies to fully leverage the capabilities of multicenter registries.

Keywords

papillary craniopharyngioma - multicenter - surgery - registry - outcomes - RAPID - extent of resection - stalk preservation - endocrinology outcomes


Publikationsverlauf

Eingereicht: 25. Februar 2025

Angenommen: 29. Juni 2025

Artikel online veröffentlicht:
18. Juli 2025

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