Markers of Aggressiveness in Craniopharyngiomas

Craniopharyngiomas (CP) are rare tumors that may be locally aggressive. The presence of functional estrogen receptors (ER) has been reported in CP and might be related to risk of recurrence. Our aim is to ascertain if the expression estrogen and progesterone receptor (PR) might be associated with to recurrence in CP. Material and Methods: Descriptive retrospective observational study of patients with confirmed histology of CP and tissue sample available admitted to Virgen Del Rocio University Hospital (Seville, Spain) from January 1967 to October 2020 were included. Estrogen and progesterone receptor expression was analyzed by Immunohistochemistry. Ki-67 levels were also analyzed. Two CP groups were considereded according to Ki67 levels: Group A (Ki67<10%) and group B (Ki67>10%). As all variables followed a non-parametric distribution, U Mann Whitney, Chi-Square, and Z-test with Benjamini-Hochberg correction were used when needed. Results: Our study population includes 80 patients (46 male and 34 female), with a median age at diagnosis of 34 years [10-50.00]. Twenty-six patients were under 18 years old (children) with a median age of 7 years [4.5-10.00], and 54 were adults (aged 18 and above) with a median age of 45 years [33-58.50]. Our data shows higher recurrence rates when Ki67 levels staining were higher than 10%: 8/14 (57.2%) in comparison with Ki67<10% (6/14, 42.9%, p=0.018). In children we found 6 samples with Ki67<10% and 6 samples with Ki67 >10%; recurrences were observed in 2/6 (33,3%) in the first group and in 6/6 (100%) in the second, respectively (p= 0,199). In adults, we found 9 and 3 patients for high and low Ki67 levels, respectively. Recurrences were observed in 4/9 (44,4%) in the group A and in 2/3 (66,7%) in the group B, respectively (p= 0,28). There were no differences between age groups. In patients with positive ER, we observed an increased rate of recurrence: 12/23 (52.17%) versus 2/13 (15,38%) in patients with negative ER stain but it was no significant. (p=0,21). No association between PR and recurrence was observed. Conclusions: In our series, patients with CP with high Ki67 levels are more likely to recur. No clear association between ER, PR expression and recurrence was observed. These findings support the use of Ki67 as a marker of recurrence in CP. Sources of Research Support: Spanish Ministry of Health, ISCIII co-funded with Fondos FEDER (PI16/00175) and Novartis Oncology Spain.