Radical Resection of Craniopharyngioma: Discussions Based on Long-term Clinical Course and Histopathology of the Dissection Plane

OBJECTIVE: Craniopharyngioma is a benign tumor. However, sometimes, this tumor may recur repeatedly even after apparent total resection. This study investigated the requirements for ideal radical treatment, based on a discussion of the long-term clinical course and pathological findings in surgical patients. METHODS: We performed 81 surgical procedures for 67 patients with craniopharyngioma between February 1990 and December 2015. We classified patients into Groups I–III according to emphasis of surgery in chronological order, so we investigated the tumor recurrence rate and the necessity for postoperative hormonal replacement. RESULTS: Multiple comparison of results from the three groups found significant differences in recurrence rate between Groups I and II (P = 0.0111) and Groups I and III (P = 0.0056). Although there were no differences in recurrence rate between Groups II and III, mortality rate of Group III was lower than that of Group II. No significant difference was seen between any group in terms of hormonal replacement. CONCLUSIONS: These results strongly suggest that the radical resection used to treat patients in Group III should be given priority as the procedure for removing craniopharyngioma.