AB022. Management of first recurrence or progression of craniopharyngioma after resection alone: a systematic review and individual-participant data meta-analysis
Abstract

AB022. Management of first recurrence or progression of craniopharyngioma after resection alone: a systematic review and individual-participant data meta-analysis

Yilong Zheng1, Shi Hui Ong1, Balamurugan Vellayappan2, Vincent Diong Weng Nga3

1NUS Yong Loo Lin School of Medicine, Singapore, Singapore; 2Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore; 3Division of Neurosurgery, National University Hospital, Singapore, Singapore

Correspondence to: Yilong Zheng, MBBS. NUS Yong Loo Lin School of Medicine, 10 Medical Dr, Singapore 117597, Singapore. Email: yilongzheng@u.nus.edu.

Background: The initial management of craniopharyngioma is generally either gross total resection (GTR) or subtotal resection (STR) with adjuvant radiotherapy (RT). However, the optimal management strategy for recurrent/progressive craniopharyngioma remains unclear.

Methods: PubMed and Embase were systematically reviewed for studies that compared the outcomes of surgery and/or RT for the first recurrence/progression of craniopharyngioma after resection alone. The exposure was the treatment that was administered for the first recurrence/progression, and the outcomes were tumor regrowth and overall survival (OS). Subgroup analyses were performed by age at the treatment for the first recurrence/progression (<18 or ≥18 years old), duration between the first treatment and the first recurrence/progression (<2 or ≥2 years), and the initial treatment that was administered (STR or GTR).

Results: Of the 2,932 studies screened, 11 studies reporting a total of 80 patients were included. Across almost all subgroups, patients who received RT for the first recurrence/progression had a significantly lower risk of tumor regrowth than those who did not, regardless of whether surgery was performed and the extent of resection. There was no significant association between the treatment administered for the first recurrence/progression and OS, except for patients with a recurrence/progression <2 years after the first treatment, where GTR was associated with a higher risk of mortality.

Conclusions: For patients with the first recurrence/progression of craniopharyngioma after resection alone, RT should be considered for better local control. In cases where RT is not administered, GTR is preferred over STR provided it can be safely performed, for improved local control.

Keywords: Craniopharyngioma; recurrent; progression; surgery; radiation

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab022/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Cite this abstract as: Zheng Y, Ong SH, Vellayappan B, Nga VDW. AB022. Management of first recurrence or progression of craniopharyngioma after resection alone: a systematic review and individual-participant data meta-analysis. Chin Clin Oncol 2024;13(Suppl 1):AB022. doi: 10.21037/cco-24-ab022

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