• Onur Ozgural, Eyup Bayatli, Halit Anil Eray, Omer Mert Ozpiskin, Suha Beton, Gokmen Kahilogullari, and Mustafa Agahan Unlu.
• Department of Neurosurgery, Ankara University, School of Medicine, Ankara, Turkey. Electronic address: onurozgural@yahoo.com.
• World Neurosurg. 2024 Nov 25; 194: 123405123405.

BackgroundThe standard treatment for craniopharyngiomas (CPs) involves either initial gross total resection or subtotal resection with adjuvant radiotherapy. However, there is no consensus regarding the management of recurrent cases. We reviewed a series of patients with CP to evaluate the characteristics of patients with recurrent/progressing CP.MethodsWe retrospectively reviewed 31 patients with biopsy-proven recurrent/progressed CP who were initially operated on at our clinic from 2015 to 2023. Demographic and clinical data, including age, sex, tumor localization, lesion size and features, radiologic findings, and endocrine, neurologic, and ophthalmologic issues, were compared between those with and without recurrence.ResultsFifteen out of 31 patients (48.4%) underwent transnasal/transsphenoidal endoscopic surgery; the remaining 16 underwent microscopic transcranial or neuroendoscopic surgery. After treatment, recurrence, and events (any medical condition related to the patient's current condition other than recurrence) were observed in 48.4% and 32.3% of the cases, respectively. There were no statistically significant disparities between patients with and without recurrence in terms of age, tumor dimensions, tumor localization, gender distribution, surgical modality, or the presence of calcifications or hydrocephalus (P > 0.05). The highest and lowest overall survival was 25 years and 6 months, respectively.ConclusionsThe management of recurrent CP is too complicated to fit into a standard treatment algorithm. Therefore, surgical treatment for these patients should be individualized and planned according to patient symptoms and radiologic findings, which is presumably a more versatile, efficient, and safe approach for recurrent CPs.Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

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