Prognosis

Quality of life is significantly impacted. Craniopharyngioma is best thought of as a chronic disease that is multi-dimensional.[70] Additionally, adults with craniopharyngioma have a substantially elevated risk of cardiovascular disease relative to the general population, added to the reduced health already common to these patients.[71]

Completely resected tumours

Recurrence risks range from 10% to 35%. The lowest recurrence rates are seen in tumours completely resected via a trans-sphenoidal surgical approach, although there is an approximately 1% operative mortality.[11][77]​ Most recurrences occur in the first 5 years after primary surgery. The rate of achieving a complete resection decreases with repeat surgery.[78]​ More than 70% of patients are functionally independent following surgery and with long-term follow-up.[25][59][60][79][80][81]

Radical surgery increases the risk of hypothalamic injury, which may manifest with hyperphagia resulting in obesity and neurobehavioural abnormalities. The consequences of hypothalamic injury are a major source of long-term morbidity.[21][38][61][81]

Following surgery, some improvement or deterioration in vision may be noted. However, visual impairment remains in up to 80% of patients.[25][59]

Multiple endocrinopathies are seen in the majority of patients (>80%), requiring hormone replacement therapy.[58][82][83]

Incompletely resected tumours treated with radiotherapy

There is a 25% to 50% recurrence risk in incomplete resected tumours.[45][46][47][56][49]​​ Most recurrences occur in the first 5 years after primary surgery. That risk decreases with the addition of adjuvant radiation after subtotal resection.[83]

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