Journal of neurological surgery. Part B, Skull base · 2025
Early Findings from the Multicenter RAPID Consortium on Papillary Craniopharyngiomas.
СтатьяНазвание и аннотация: Перевод в очереди
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Catalino Michael P, Pham Duy, Rennert Robert C, Couldwell William T, Evans James J, Callopy Calen, Kim Won, Pacione Donato, Suryadevara Carter M, Kim Albert, Silverstein Julie, Chicoine Michael, Gardner Paul A, Barkhoudarian Garni, Miranda Juan C Fernandez, Benjamin Carolina, Kshettry Varun R, Zada Gabriel, Gompel Jamie J Van, Palit Sandhya R, Zwagerman Nathan, Cheok Stephanie, Prevedello Daniel, Wu Kyle C, Mamelak Adam, Pacult Mark, Little Andrew, Karsy Michael
Аннотация
BACKGROUND: Craniopharyngiomas are rare parasellar tumors, and papillary craniopharyngiomas (PCPs) represent 8 to 20% of cases.
DESIGN: Interim analysis of retrospective data collected from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID).
SETTING: Fourteen U.S.-based academic skull base centers between 2011 and 2023.
PARTICIPANTS: Patients with PCPs.
MAIN OUTCOME MEASURES: Demographic, imaging, surgical, and outcome variables.
RESULTS: Ninety-nine patients with PCPs were included. The mean age was 51.8 ± 14.7, and 57.6% were male. Most tumors showed mixed cystic/solid components (67.5%), were transinfundibular (50.0%), and were treated with an endoscopic endonasal approach (74.5%), with 51.1% demonstrating gross total resection (GTR). Pituitary stalk was preserved in 51.9%. Permanent arginine vasopressin deficiency was seen in 67.1% and was associated with pituitary stalk sacrifice ( p = 0.003). Cerebrospinal fluid leak was the most common nonendocrine postsurgical, 30-day complication (9.1%), reason for return to the operating room (3.1%), and reason for 90-day readmission (8.1%). Most patients (63.9%) received no adjuvant therapy; GTR was associated with decreased radiotherapy use ( p = 0.0001). BRAF V600E mutation was detected in 64/69 tumors tested, although only one patient was treated with a BRAF inhibitor. A mean follow-up of 12.3 ± 14.6 months was seen for the group.
CONCLUSIONS: RAPID consortium enabled the largest real-world clinical information dataset for PCPs. Early findings support that GTR and stalk preservation are important to outcomes. Iterative analysis and discussion of data led to the generation of a framework for future studies to fully leverage the capabilities of multicenter registries.
DESIGN: Interim analysis of retrospective data collected from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID).
SETTING: Fourteen U.S.-based academic skull base centers between 2011 and 2023.
PARTICIPANTS: Patients with PCPs.
MAIN OUTCOME MEASURES: Demographic, imaging, surgical, and outcome variables.
RESULTS: Ninety-nine patients with PCPs were included. The mean age was 51.8 ± 14.7, and 57.6% were male. Most tumors showed mixed cystic/solid components (67.5%), were transinfundibular (50.0%), and were treated with an endoscopic endonasal approach (74.5%), with 51.1% demonstrating gross total resection (GTR). Pituitary stalk was preserved in 51.9%. Permanent arginine vasopressin deficiency was seen in 67.1% and was associated with pituitary stalk sacrifice ( p = 0.003). Cerebrospinal fluid leak was the most common nonendocrine postsurgical, 30-day complication (9.1%), reason for return to the operating room (3.1%), and reason for 90-day readmission (8.1%). Most patients (63.9%) received no adjuvant therapy; GTR was associated with decreased radiotherapy use ( p = 0.0001). BRAF V600E mutation was detected in 64/69 tumors tested, although only one patient was treated with a BRAF inhibitor. A mean follow-up of 12.3 ± 14.6 months was seen for the group.
CONCLUSIONS: RAPID consortium enabled the largest real-world clinical information dataset for PCPs. Early findings support that GTR and stalk preservation are important to outcomes. Iterative analysis and discussion of data led to the generation of a framework for future studies to fully leverage the capabilities of multicenter registries.