Abstract
PurposeCraniopharyngioma is one of the most frequent benign tumours of the central nervous system in the paediatric population. Although it is a benign tumour according to the WHO classification, it significantly deteriorates the patient’s quality of life. The aim of this study is to assess if proliferation index Ki67 can be a useful marker of the risk of craniopharyngioma’s recurrence.MethodsExpression of Ki67 was examined in 85 specimens of primary craniopharyngioma and in 11 specimens of the recurring tumour. In all the cases, adamantinomatous type of craniopharyngioma was diagnosed. Values of Ki67 expression were compared between patients with and without recurrence, between patients with progression and relapse and between primary and recurrent tumours.ResultsNo statistically significant differences were found between proliferation index Ki67 values in tumours with recurrence and without (median values 2.5% and 3%, respectively, p = 0.69). The median value of proliferation index Ki67 in progression group was 1% and in the relapse group 4%; no statistical significance between those groups was found (p = 0.067). The median value of proliferation index Ki67 in primary tumours was 3% (0–20%) and in recurrent tumours it was 5% (0–14%). Despite the lack of statistical significance (p = 0.61), a tendency towards higher values of Ki67 in recurring tumours in comparison with primary tumours was shown.ConclusionsProliferation index Ki67 is not a reliable prognostic factor of craniopharyngioma’s recurrence.
Highlights
IntroductionCraniopharyngioma is a benign, partially cystic epithelial tumour of the sellar region with two clinical and histopathological variants (adamantinomatous and papillary), which is considered to be of grade I malignancy according to WHO criteria [1]
Craniopharyngioma is a benign, partially cystic epithelial tumour of the sellar region with two clinical and histopathological variants, which is considered to be of grade I malignancy according to WHO criteria [1].Craniopharyngioma contributes to 2–5% of all intracranial tumours in the whole population [2] and 5.6–14.1% among craniopharyngioma is a histopathologically benign tumour according to the WHO classification [1], clinically, it is considered ‘partially malignant’
Recurrence rate is higher after partial resection than after total resection, but it can be as low as 20% following partial resection and as high as 50% in case of total resection, as reported in some studies [12, 13]
Summary
Craniopharyngioma is a benign, partially cystic epithelial tumour of the sellar region with two clinical and histopathological variants (adamantinomatous and papillary), which is considered to be of grade I malignancy according to WHO criteria [1]. Craniopharyngioma is a histopathologically benign tumour according to the WHO classification [1], clinically, it is considered ‘partially malignant’. Aggressive behaviour of the tumour is reflected by its tendency towards damaging of adherent structures and an inclination for recurrence, invasive growth and higher mortality of patients suffering from it in comparison with the rest of the population [11]. Craniopharyngioma’s recurrence is one of the most serious problems for neurosurgeons, due to difficulty in predicting it and the high morbidity and mortality rates in removing recurrent tumours. Recurrence rate is higher after partial resection (on average 71%) than after total resection (on average 21%), but it can be as low as 20% following partial resection and as high as 50% in case of total resection, as reported in some studies [12, 13].
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