Impact of Pituitary Stalk Preservation on Tumor Recurrence/Progression and Surgically Induced Endocrinopathy After Endoscopic Endonasal Resection of Suprasellar Craniopharyngiomas

• DOI: 10.3389/fneur.2021.753944
• Publication Date: 2021-11-04T04:43:48Z
• Authors: Zhengyuan Chen; Zengyi Ma; Wenqiang He; Xuefei Shou; Zhao Ye; Yichao Zhang; Qilin Zhang; Nidan Qiao; Xiang Zhou; Xiaoyun Cao; Min He; Zhaoyun Zhang; Hongying Ye; Yiming Li; Shiqi Li; Yao Zhao; Ming Shen; Yongfei Wang
• Keywords: Pituitary stalk; Tumor progression; Craniopharyngioma; Progression-free survival

Objective: To investigate the factors associated with recurrence/progression after endoscopic endonasal resection of suprasellar craniopharyngiomas. Special attention was paid to assess impact pituitary stalk preservation on tumor and endocrinological outcomes. Methods: We retrospectively recruited 73 patients craniopharyngiomas undergone approach (EEA) surgery from September 2014 May 2019 assessed their clinical characteristics, surgical outcomes, recurrence/progression. Stalk or sacrifice determined by reviewing operative records, videos, post-operative magnetic resonance imaging. Results: Gross total (GTR) achieved in 51 cases (69.9%). Tumor recurrence seen 5 (9.8%) progression 8 (36.4%), respectively. GTR (OR = 0.248 CI 0.081–0.759; p 0.015) only independent factor influencing Kaplan-Meier survival analysis showed that mean recurrence/progression-free were 53 (95% 48–59) 39 28–50) months, respectively, without ( 0.011). Pituitary more common peripheral type tumors (83% vs. 30%, < 0.01). Preserving does not appear decrease percentage (75.5% 55.0%, 0.089), increase rate (12.5% 0%, 0.508) (46.2% 22.2%, 0.486). However, surgically induced hypothyroidism (60.5% 100%, 0.041) diabetes insipidus (35.1% 81.8%, 0.017) significantly lower preservation. For who had hypopituitarism before EEA, there no difference between those regarding > 0.05). Conclusion: is predictor EEA for risk non-GTR might help reduce insipidus. recommend preserving normal function, especially On other hand, could be considered central severe pre-operative endocrinopathy.