, Volume 21, Issue 4, pp 371–378 | Cite as

Low concordance between surgical and radiological assessment of degree of resection and treatment-related hypothalamic damage: results of KRANIOPHARYNGEOM 2007

  • Hermann L. Müller
  • Julia Reichel
  • Svenja Boekhoff
  • Monika Warmuth-Metz
  • Maria Eveslage
  • Junxiang Peng
  • Jörg Flitsch



Assessment of presurgical hypothalamic involvement (psHI) and treatment-related hypothalamic damage (trHD) is relevant for the decision on risk-adapted treatment and rehabilitation strategies in craniopharyngioma.

Patients and methods

129 surgical reports of childhood-onset craniopharyngioma patients recruited 2007–2014 in KRANIOPHARYNGEOM 2007 were analyzed. Data on psHI were available based on surgeon’s (63%), reference neuroradiologist’s (95%), and local radiologist’s (23%) assessment. The surgical degree of resection (DoR) was assessed by neurosurgeon (95%), reference neuroradiologist (73%), and local radiologist (61%). TrHD was assessed by neurosurgeon (33%), by reference neuroradiologist (95%), and by local radiologist (2%). Neurosurgical center size was categorized based on patient load.


Surgical assessments on psHI (n = 78), DoR (n = 89) and trHD (n = 42) as documented in surgical reports could be compared with the assessment of respective parameters by reference neuroradiologist. Differences with regard to DoR (p = 0.0001) and trHD (p < 0.0001) were detectable between surgeon’s and reference neuroradiologist’s assessment, whereas psHI was assessed similarly. Concordance for DoR and trHD was observed in 48 and 62%, respectively. Surgeons estimated a higher rate of complete resections and a lower rate of trHD. Neuroradiological reference assessment of trHD had higher predictive value for hypothalamic sequelae then surgical assessment. Observed differences were not related to neurosurgical center size.


Observed differences between surgical and neuroradiological estimation of risk factors in craniopharyngioma support the necessity of neuroradiological reference review to assure standards of quality. This could be established by central internet-based neuroradiological review in KRANIOPHARYNGEOM 2007. Standardization of surgical reports including specific assessment of tumor/damage location is recommended.


Craniopharyngioma Neurosurgery Hypothalamus Obesity Quality of life Pediatrics 



H. L. Müller is supported by the German Childhood Cancer Foundation, Bonn, Germany (DKS 2014.13).

Compliance with ethical standards

Conflict of interest

This manuscript was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatrics and Pediatric Hematology/Oncology, Klinikum Oldenburg AöRMedical Campus University OldenburgOldenburgGermany
  2. 2.Department of NeuroradiologyUniversity HospitalWürzburgGermany
  3. 3.Institute of Biostatistics and Clinical ResearchUniversity of MünsterMunsterGermany
  4. 4.Department of Neurosurgery, Nanfang HospitalSouthern Medical UniversityGuangzhouChina
  5. 5.Department of NeurosurgeryUniversity Hospital Hamburg-Eppendorf (UKE)HamburgGermany

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