Tumor Classification and Its Application in Surgical Treatment of Craniopharyngioma

NCT00949156 | Unknown DMC

• 1 other identifier: SMUneurosurgery
• Study Type: observational
• Target: 238
• Locations: 1 country
• Sites: 1

Brief Summary

With the preliminary anatomical and histological study, the membranous structures of the sellar region was considered to be closely related with the growth pattern of Craniopharyngiomas(CP). By combined considering of the tumor-membrane relationship, this project was trying to classify the CP through retrospectively summarizing the pre- and postoperative imaging (MRI and CT), the intrasurgical findings, and the endocrine data of 198 CPs with primary surgery in our hospital (since 1997 until now). As a result, a distinct and systematic CP classification was proposed. The possible originate site, surgical skills and postoperative treatment of all the subtype tumors were discussed and analyzed to provide a normalized surgical treatment for this kind of tumor. Then in the prospective cohort, the anticipated 100 CP patients will accept the normalized surgical treatment. And by the long term follow up, the postsurgical quantity of life (QOL) of patients was evaluated with aspect in cognition, circadian rhythm, endocrine, Water-Electrolyte and body weight, et al. By comparing with the long-term results of the retrospective cohort, the totally follow up data was statistically analyzed to assess the rationality of this standard treatment of CP.

Conditions

Craniopharyngioma

Keywords

Craniopharyngiomas; Classification; Membranous structure; Pituitary stalk; Obesity; panhypopituitarism

Outcome Measures

Primary Outcomes (3)

• The course of suprasellar arachnoid mater and pia mater, and the construction of all meninges of the sellar region was observed and measured by microscopy.

  1~2 years

• Through the analysis of the pre- and postoperative imaging and intrasurgical findings of CP, and combined considering of the tumor-membrane relationship, the classification of CP was proposed.

  1~2 years

• After long term follow up of CP patients, the normalized treatment was evaluated and modified.

  3~5 years

Study Arms (2)

Retrospective cohort

The 198 cases of CP with primary surgery in our hospital (since July, 1997 until now) were divided into three topographical groups based on the pre-operative MRI, intraoperative findings and the tumor-membrane relationship. The presurgical manifestation, the different surgical approach, intraoperative techniques, and postoperative complication were described and analyzed to establish a normalized surgical treatment of individual CP patient, which has the highest rate of the totally tumoral resection and the lowest rate of the hypothalamic injury.

Prospective cohort

The anticipated 40 cases of CP were surgical treated by our standard procedure, which is recruited in the prospective cohort. With the long-term follow up, QOL including the cognition, circadian rhythm, endocrine, Water-Electrolyte, and body weight et al were evaluated to assess the rationality of the treatment. Then according to the results, the surgical treatment was modified, and the endocrinic substitution therapy was also been developed.

Procedure: Different surgical approach and techniques being used to treat three subtype of CP

Interventions

Different surgical approach and techniques being used to treat three subtype of CP PROCEDURE

According to the presurgical MRI, with the analysis of the morphological characteristic of three subtype of CP, different surgical approach and intrasurgical skills were used to treat tumors with trying to total remove tumor and avoid the hypothalamus injury.

Prospective cohort

Eligibility Criteria

• Age: 1 Year - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The clinical data of 198 patients who underwent primary microsurgery for craniopharyngiomas at our institute since July, 1997 until now was analysed retrospectively. The anticipated 40 CP patients in the following two years were recurited in the prospective cohort, who will be surgical treated according to the standard process.

You may qualify if:

• Primary craniopharyngioma(initial diagnosis);
• The sufficient pre-, intra and postoperative information (including patient's information, presenting manifestation, the pre- and postsurgical MRI, CT; Intrasurgical image, and endocrine data);
• After surgery, patients are followed periodically. Quality of life is assessed at baseline and then periodically thereafter.

Sponsors & Collaborators

• Southern Medical University, China: lead

Study Sites (1)

Neurosurgery department, Nanfang hospital

Guangzhou, Guangdong, 510515, China

Location

Related Publications (1)

• Peng JX, Yang L, Huang GL, Liu Y, Zhang SC, Pan J, Qi ST. Development of a novel score to predict probability of growth without growth hormone after resection of paediatric craniopharyngiomas: relative to tumour growth pattern. J Endocrinol Invest. 2020 Jun;43(6):737-747. doi: 10.1007/s40618-019-01154-y. Epub 2019 Dec 18.

  PMID: 31853886 DERIVED

MeSH Terms

Conditions

Craniopharyngioma; Obesity; Combined Pituitary Hormone Deficiency

Condition Hierarchy (Ancestors)

Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Nerve Tissue; Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Songtao Qi, MD, PhD

  Director, Neurosurgery department, Nanfang Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: July 21, 2009
• First Posted: July 30, 2009
• Study Start: September 1, 1997
• Primary Completion: October 1, 2009
• Study Completion: December 1, 2015
• Last Updated: September 15, 2010

Record last verified: 2010-09

Locations

CN (1)