{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:29:56Z","timestamp":1787167796612,"version":"build-2736575974"},"reference-count":125,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>Optimal treatment of primary and recurrent craniopharyngiomas remains controversial. Radical resection and limited resection plus radiation therapy yield similar rates of disease control and overall survival. The data are much less clear for recurrent tumors. The authors report their experience with radical resection of both primary and recurrent craniopharyngiomas in children and compare the outcomes between the 2 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was performed in 86 children younger than 21 years of age who underwent a total of 103 operations for craniopharyngioma between 1986 and 2008; these were performed by the senior author. The goal was resection with curative intent in all patients. Two patients were lost to follow-up and were excluded from analysis. The mean age at the time of surgery was 9.6 years, and the mean follow-up was 9.0 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 57 children with primary tumors underwent gross-total resection (GTR). A GTR was achieved in significantly fewer children with recurrent tumors (18 [62%] of 29). There were 3 perioperative deaths (3%). Tumor recurred after GTR in 14 (20%) of 71 patients. Overall survival and progression-free survival were significantly better in patients with primary tumors at time of presentation to the authors' institution. There were no significant differences in the neurological, endocrinological, visual, or functional outcomes between patients with primary and those with recurrent tumors. Factors negatively affecting overall survival and progression-free survival include subtotal resection (recurrent tumors only), tumor size \u2265 5 cm, or presence of hydrocephalus or a ventriculoperitoneal shunt. Prior radiation therapy and increasing tumor size were both risk factors for incomplete resection at reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the hands of surgeons with experience with craniopharyngiomas, the authors believe that radical resection at presentation offers the best chance of disease control and potential cure with acceptable morbidity. While GTR does not preclude recurrence and is more difficult to achieve in recurrent tumors, especially large and previously irradiated tumors, radical resection is still possible in patients with recurrent craniopharyngiomas with morbidity similar to that of primary tumors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2009.7.peds09215","type":"journal-article","created":{"date-parts":[[2009,12,31]],"date-time":"2009-12-31T11:35:23Z","timestamp":1262259323000},"page":"30-48","source":"Crossref","is-referenced-by-count":148,"title":["Efficacy and safety of radical resection of primary and recurrent craniopharyngiomas in 86 children"],"prefix":"10.3171","volume":"5","author":[{"given":"Robert E.","family":"Elliott","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsivia","family":"Hochm","sequence":"additional","affiliation":[{"name":"Divisions of Biostatistics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilana","family":"Belitskaya-Levy","sequence":"additional","affiliation":[{"name":"Divisions of Biostatistics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Wisoff","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Pediatric Neurosurgery, New York University School of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey H.","family":"Wisoff","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"},{"name":"Pediatrics, and"},{"name":"Pediatric Neurosurgery, New York University School of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0050030","series-title":"Neurosurgery","first-page":"ONS331","article-title":"The petrosal approach for the resection of retrochiasmatic craniopharyngiomas","volume":"62","author":"Al-Mefty","year":"2008"},{"key":"b2-0050030","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1227\/00006123-198510000-00009","article-title":"Microsurgery for giant craniopharyngiomas in children","volume":"17","author":"Al-Mefty","year":"1985"},{"key":"b3-0050030","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1007\/s00381-005-1185-6","article-title":"Individualized treatment of pediatric craniopharyngiomas","volume":"21","author":"Albright","year":"2005"},{"key":"b4-0050030","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1007\/BF00262259","article-title":"Surgery of large retrochiasmatic craniopharyngiomas in children","volume":"6","author":"Ammirati","year":"1990"},{"key":"b5-0050030","series-title":"Pediatr Rehabil","doi-asserted-by":"publisher","first-page":"63","DOI":"10.3109\/17518429709025849","article-title":"Neurobehavioural sequelae following cranial irradiation and chemotherapy in children: an analysis of risk factors","volume":"1","author":"Anderson","year":"1997"},{"key":"b6-0050030","series-title":"Br J Cancer","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1054\/bjoc.1999.0912","article-title":"Cognitive and academic outcome following cranial irradiation and chemotherapy in children: a longitudinal study","volume":"82","author":"Anderson","year":"2000"},{"key":"b7-0050030","series-title":"J Clin Exp Neuropsychol","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1080\/13803390409609792","article-title":"Impairments of attention following treatment with cranial irradiation and chemotherapy in children","volume":"26","author":"Anderson","year":"2004"},{"key":"b8-0050030","series-title":"Kobe J Med Sci","first-page":"123","article-title":"Treatment of recurrent craniopharyngiomas","volume":"49","author":"Barua","year":"2003"},{"key":"b9-0050030","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"22","DOI":"10.3171\/jns.1986.65.1.0022","article-title":"Surgical management of craniopharyngiomas. 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