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Characteristics and overall survival in pediatric versus adult craniopharyngioma: a population-based study

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Abstract

Purpose

This study uses a large-population national database to describe the presenting clinical, sociodemographic, treatment, and clinical outcome differences between pediatric and adult craniopharyngiomas.

Methods

This study utilized the 2004–2015 National Cancer Database and was queried for all cases of craniopharyngioma. Multivariate Cox proportional-hazards analysis was used to determine clinical and sociodemographic factors associated with mortality. Kaplan-Meier log-rank test determined differences in overall survival (OS) time.

Results

The cohort consisted of 3638 patients, with 816 (22.4%) pediatric (≤ 18 years) patients. Pediatric patients presented with significantly higher frequency of large tumors (> 3 cm, 54.1 vs. 31.8%, p < 0.001), lower frequency of papillary subtype (0.9 vs. 11.5%, p < 0.001), and were exclusively treated at academic centers (100 vs. 73.4%, p < 0.001). Pediatric patients had significantly higher rates of adjuvant radiation (34.3 vs. 22.3%; p < 0.001), and had significantly lower 90-day mortality (1.6 vs. 4.9%; p < 0.001); however, no significant differences in extent of resection (p = 0.93), length of hospital stay (p = 0.53), and 30-day readmissions (p = 0.06) were observed between pediatric and adult patients. On Kaplan-Meier log-rank test, there were no significant differences in OS in pediatric patients receiving gross total resection (GTR), subtotal resection (STR), or STR + adjuvant radiation (p = 0.68). Lastly, when comparing endoscopic and open surgical approaches in pediatric patients, there were no significant differences in extent of surgical resection (p = 0.81), length of hospital stay (p = 0.54), 30-day readmissions (p = 0.22), and 90-day mortality (p = 0.80).

Conclusion

Craniopharyngioma has improved OS in pediatric compared to adult patients. Pediatric craniopharyngioma patients are best managed within multidisciplinary teams at academic centers with an individualized approach.

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Funding

The research reported in this publication was in part supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number T32GM008208 to BML. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Medical Scientist Training Program, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA, USA

    Brandon M. Lehrich

  2. Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, 101 The City Drive South, Orange, CA, 92868-3201, USA

    Khodayar Goshtasbi & Edward C. Kuan

  3. Department of Neurological Surgery, University of California, Irvine, Orange, CA, USA

    Frank P. K. Hsu & Edward C. Kuan

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  1. Brandon M. Lehrich
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  2. Khodayar Goshtasbi
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  3. Frank P. K. Hsu
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  4. Edward C. Kuan
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Correspondence to Edward C. Kuan.

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Lehrich, B.M., Goshtasbi, K., Hsu, F.P.K. et al. Characteristics and overall survival in pediatric versus adult craniopharyngioma: a population-based study. Childs Nerv Syst 37, 1535–1545 (2021). https://doi.org/10.1007/s00381-021-05094-y

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