{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T22:54:11Z","timestamp":1789080851014,"version":"build-2803163510"},"reference-count":17,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Craniopharyngiomas are rare Sellar and suprasellar tumors that can cause significant visual, endocrine, and hypothalamic morbidity. Treatment decisions in older adults are complicated by higher comorbidity burden, reduced physiological reserve, and limited data especially for the very elderly. Because most studies group all patients \u226565 together, the survival impact of surgery and radiotherapy in elderly subgroups remains unclear. Methods: A retrospective cohort study was conducted using SEER 17 (2000\u20132022). Patients aged \u226550 years with histologically confirmed craniopharyngioma were categorized as non-elderly (50\u201364), elderly (65\u201379), or very elderly (\u226580). Demographic and clinical characteristics were compared using Chi-square tests and two-sample t-tests. Overall survival (OS) was evaluated using Kaplan\u2013Meier analyses and multivariable Cox proportional hazards models. Results: A total of 1259 patients met inclusion criteria. OS decreased with age. In the 50\u201364 cohort, subtotal resection (STR) and gross total resection (GTR) significantly improved survival, and radiotherapy provided additional benefit. In the 65\u201379 cohort, neither resection nor radiotherapy significantly influenced OS. In the \u226580 cohort, STR was associated with worse survival relative to no resection (HR 2.21; p = 0.0349), while GTR and radiotherapy did not improve outcomes. Conclusions: The effect of craniopharyngioma treatment varies by age. Surgery and radiotherapy benefit younger patients, whereas adults aged 65\u201379 may gain symptomatic but not survival advantages. In patients \u226580, STR may reduce survival, underscoring the need for individualized treatment plans aligned with patient goals and physiological reserve.<\/jats:p>","DOI":"10.3390\/jcm15010195","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:50:42Z","timestamp":1766969442000},"page":"195","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Management Considerations for Craniopharyngioma in Geriatric Populations: An Assessment of the Surveillance, Epidemiology, and End Results Database"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4375-8948","authenticated-orcid":false,"given":"Jacob","family":"Gould","sequence":"first","affiliation":[{"name":"Kreiger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjit","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Johns Hopkins University, Baltimore, MD 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saarang","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, Seton Hall University, South Orange, NJ 07079, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Yaffe","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, 3303 S. Bond Avenue, Building 1, Eighth Floor, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California San Diego, San Diego, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lou","family":"Blanpain","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, 3303 S. Bond Avenue, Building 1, Eighth Floor, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8412-0437","authenticated-orcid":false,"given":"Julian","family":"Gendreau","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, 3303 S. Bond Avenue, Building 1, Eighth Floor, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"ref_1","unstructured":"Karsonovich, T., Shafiq, I., and Mesfin, F.B. (2025, November 15). Craniopharyngioma, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK519027\/."},{"key":"ref_2","unstructured":"Feingold, K.R., Adler, R.A., Ahmed, S.F., Anawalt, B., Blackman, M.R., Chrousos, G., Corpas, E., de Herder, W.W., Dhatariya, K., and Dungan, K. (2025, November 15). 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