{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:02:45Z","timestamp":1780448565843,"version":"3.54.1"},"reference-count":68,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Craniopharyngiomas are challenging lesions, and aggressive resections may cause significant postoperative morbidity and mortality. To mitigate morbidity, a potential strategy of subtotal resection (STR) and adjuvant radiation therapy (RT) has been used, but its impact on survival when compared to gross-total resection (GTR) has been under-investigated. Thus, the objective of this study was to analyze short-term mortality between patients undergoing STR \u00b1 RT and GTR, and differences in overall survival (OS) between patients undergoing STR, STR + RT, and GTR in a large, nationally representative database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors queried the National Cancer Database for patients diagnosed with craniopharyngioma between 2004 and 2017. Tumor characteristics, treatment strategies, and extent of resection were analyzed. Endpoints were 3-month mortality rate and OS, which were compared between treatment modalities. Firth\u2019s logistic regression was used to analyze 3-month mortality and was adjusted for age, sex, Charlson Comorbidity Index score, histopathological diagnosis, income quartile, insurance payor, and maximal tumor diameter. Differences in survival between treatment modalities were compared with log time-to-event analyses after excluding deaths occurring within 3 months to control for immortal time bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 1460 adult and 390 pediatric patients were included. Adults undergoing STR \u00b1 RT had a lower rate of 3-month mortality compared to those undergoing GTR in adjusted analysis (2.8% vs 4.6%, odds ratio 0.42; p = 0.03). Survival curves for the STR + RT and GTR cohorts did not significantly differ (p = 0.198). A strategy of STR alone showed worse OS compared with GTR and STR + RT (p &lt; 0.01). The average follow-up length for adults was 65.5 months. For pediatric patients, 3-month mortality for those undergoing GTR and STR \u00b1 RT was similar (0% vs 1%, respectively; p = 0.33). Additionally, compared to GTR, there were no significant differences in OS between STR + RT (p = 0.41) and STR alone (p = 0.44). The average follow-up length for the pediatric cohort was 79 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>STR + RT was associated with a favorable perioperative mortality profile when compared with GTR and provided similar long-term survival outcomes. Therefore, STR + RT may be considered when GTR carries significant risks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.2.focus251161","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:57Z","timestamp":1779840057000},"page":"E8","source":"Crossref","is-referenced-by-count":0,"title":["The role of postoperative radiation therapy in short- and long-term survival for craniopharyngiomas: a National Cancer Database analysis"],"prefix":"10.3171","volume":"60","author":[{"given":"A. Yohan","family":"Alexander","sequence":"first","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"},{"name":"Medical School, University of Minnesota, Minneapolis, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Agosti","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgos","family":"Michalopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Kerezoudis","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Maria","family":"Fontanella","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Peris Celda","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"},{"name":"Department of Otolaryngology\/Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Pituitary","first-page":"56","article-title":"Childhood craniopharyngioma","volume":"16","author":"M\u00fcller HL","year":"2013","unstructured":"M\u00fcller HL. 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