CR-10: ONLINE SURVEY ON THE MANAGEMENT OF PAEDIATRIC CRANIOPHARYNGIOMAS

INTRODUCTION: Paediatric craniopharyngiomas pose a challenge due to proximity of important neural structures and their potential for recurrence in spite of benign histology. Aggressive approach towards surgical resection often leads to bad overall patient outcome in terms of quality of life whereas limited resection is fraught with its own drawbacks. Although there are a number of modalities available to supplement surgery, there is no uniformity in utilising these. MATERIAL AND METHODS: The online survey includes two sections. One section will allow to collect basic information about neurosurgical units and service provided. The second section consists of 8 different clinical scenario with related scans and involves a multiple choice questionnaire about management pathway of hydrocephalus, surgical procedures, radiotherapy and recurrences' treatment. The survey has been circulated through mailing lists involving the major international paediatric neurosurgery societies. RESULTS: We received 91 responses. Management of hydrocephalus received an overall agreement of 75%, surgical management of 70% and management of residual tumour of 45%. Transphenoidal approach is the first choice for resection in units with an on-site skull base surgeon. 57% of centres has departmental protocol, and 51% has designated surgeon. Majority of centres can provide on-site skull base surgeon, endocrinologist, oncologist and neuro-opthalmologist. Two third of units delivers a multidisciplinary clinic. Intracystic treatment is used in most centres. CONCLUSION: The survey showed a significant lack of agreement in terms of choice of approach for resection and management of residual tumour. Intracystic treatment is widely used but with no agreement in terms of modality of treatment.