Incidence, management and outcome of craniopharyngioma in Kenyatta National Hospital

Abstract

BACKGROUND Craniopharyngiomas are benign intracranial tumours with a bimodal distribution, with peak incidence in children aged 5-14 years and older adults aged 65-74 years. There is no clear consensus reached with regards to its treatment and no reliable criteria for accurately predicting the clinical outcome of these tumours. This study focused on the presentation, management and outcome of patients with craniopharyngiomas. METHODOLOGY This was a combined retrospective and prospective study for patients admitted at KNH with a confirmed diagnosis of craniopharyngiomas. The study covered the period January 2003 to December 2008 and a follow up of three-six months at the Neurosurgery clinic was undertaken. The retrospective part of the study was from January 2003 to October 2007 while the prospective was from November 2007 to December 2008. The following data was entered into a standardized questionnaire: ~demographics, clinical presentation, management and outcome. Data was processed using appropriate analytical packages including SPSS, Chi square and descriptive statistics such as median, mean and frequency distribution was used to analyze data. Results are presented in .charts, graphs and tables followed by a discussion. Conclusions and recommendations made there after. RESULTS There were 20 males and 21 females all totaling to 41. Majority (68.3%) were in the age, bracket o~19 years. The incidence of craniopharyngioma at Kenyatta National Hospital is 7.1%. majority of patients presented with headache and visual disturbances, 90% and 78% respectively. Most patients (56.1%) were dead within six months of follow-up. CONCLUSIONS There was no significant association between outcome with age and gender. Outcome was better in patients done biopsy/ partial resection, patients who had radiotheraphy in addition to surgery although not statistically significant. Only 42.5% of the patients had radiotherapy in addition to surgery which had a positive impact on the outcome. There is need for patients to receive post-operative radiotherapy and adequate follow-up investigations to assist in patient rehabilitation/care.