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      The safety and efficacy of endoscopic endonasal approach in the treatment of recurrent craniopharyngioma : A protocol for systematic review and meta-analysis

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          Abstract

          Background:

          Craniopharyngioma is the most challenging brain tumor with a high recurrence rate. Some scholars have shown that endoscopic endonasal approach (EEA) can achieve a higher total tumor resection rate and significantly reduce the incidence of complications and mortality. However, there is still no consensus on the surgical approach for recurrent craniopharyngioma. The purpose of this study is to evaluate the safety and efficacy of EEA in the treatment of recurrent craniopharyngioma.

          Methods:

          We will search 7 electronic databases (PubMed, EMBASE, Web of Science, the Cochrane Library, PsycINFO, AMED, Scopus) to collect related randomized controlled trials (RCTs). The resection rate, recurrence rate and progression-free survival rate will be regarded as the primary outcome, and the incidence of complications will be regarded as the secondary outcome. Endnote Software X9.0 will be used to filter articles, Review Manager Software 5.2 and STATA software 16.0 will be used for analysis and synthesis.

          Results:

          We will integrate existing studies to assess the safety and efficacy of EEA in the treatment of recurrent craniopharyngioma.

          Conclusion:

          Our study will provide EEA as an effective and safe treatment for recurrent craniopharyngioma.

          Registration number:

          International Prospective Register of Systematic Reviews (PROSPERO): CRD42020199860

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          Most cited references26

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          Outcome of craniopharyngioma in children: long-term complications and quality of life

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            Surgical management of craniopharyngiomas in adult patients: a systematic review and consensus statement on behalf of the EANS skull base section.

            Craniopharyngiomas are locally aggressive neuroepithelial tumors infiltrating nearby critical neurovascular structures. The majority of published surgical series deal with childhood-onset craniopharyngiomas, while the optimal surgical management for adult-onset tumors remains unclear. The aim of this paper is to summarize the main principles defining the surgical strategy for the management of craniopharyngiomas in adult patients through an extensive systematic literature review in order to formulate a series of recommendations.
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              Long-term outcomes for surgically resected craniopharyngiomas.

              This retrospective study critically analyzed the long-term functional outcomes and tumor recurrence rates for surgically treated craniopharyngiomas. This study used an outcome classification system that included functioning vision, independent versus dependent living, Karnofsky Performance Scale scores, academic levels, work status, and psychological status. Tumor recurrence rates were analyzed with respect to the extent of surgical resection and adjunctive radiotherapy. For 121 patients, with a mean follow-up period of 10 years, the overall "good outcome" rate was 60.3%. Factors associated with poor outcomes included lethargy at presentation, visual deterioration, papilledema, tumor calcification, hydrocephalus, and tumor adhesiveness at surgery. Gross total resection was associated with good outcomes (P = 0.017) and decreased risk of recurrence (P = 0.024). Subtotal resection was associated with increased risk of tumor recurrence (P = 0.0235). The highest risk of recurrence was in the subtotal resection/no radiation group (P = 0.0001). There were no differences in outcomes or recurrence rates between pediatric and adult patients. There were also no differences in outcomes or recurrence rates between papillary and adamantinous tumors. Approximately one-third of patients exhibited morbid obesity, and permanent diabetes insipidus was observed for 25 patients. A rigorous evaluation of outcomes for tumors such as craniopharyngiomas must consider not only the extent of resection, as judged by postoperative imaging, but also the long-term physical, intellectual, and psychological functioning of the patients.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                4 December 2020
                04 December 2020
                : 99
                : 49
                : e22995
                Affiliations
                Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China.
                Author notes
                []Correspondence: Tingrong Zhang, Department of Neurosurgery, The First Affifiliated Hospital of Xinjiang Medical University, No. 137, Liyushan South Road, Urumqi 830054, Xinjiang Uygur Autonomous Region, China (e-mail: zhangtingrong999@ 123456sohu.com ).
                Author information
                http://orcid.org/0000-0002-3493-7403
                Article
                MD-D-20-08841 22995
                10.1097/MD.0000000000022995
                7717812
                b9a8617c-8cef-4f5d-b084-e2a701297a96
                Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 28 September 2020
                : 1 October 2020
                Funding
                Funded by: the Special program for young medical science and Technology professionals in health care of The Autonomous Region of China
                Award ID: WJWY-202147
                Award Recipient : Shaoshan Li
                Categories
                7100
                Research Article
                Study Protocol Systematic Review
                Custom metadata
                TRUE
                UNITED STATES

                efficacy,endoscopic endonasal approach,meta-analysis,protocol,recurrent craniopharyngioma,safety,systematic review

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