OBJECT: The current treatment of @entity976 is evolving into one of a multimodal approach in which the aim is disease control and improved preservation of quality of life (QOL). To date, an appropriate classification system with which to individualize treatment is absent. The objectives of this study were to identify preoperative prognostic factors in @entity1 with @entity976 and to develop a risk-based treatment algorithm. METHODS: The authors reviewed data obtained in a retrospective cohort of 66 @entity1 (mean age 7.4 years, mean follow-up period 7 years) who underwent resection between 1984 and 2001. Postoperative recurrence rates, vision status, and endocrine function were consistent with those reported in the literature. The postoperative morbidity was related to @entity1640 . The preoperative magnetic resonance imaging grade, clinically assessed @entity1640 function, and the sugeon's operative experience (p = 0.007, p = 0.047, p = 0.035, respectively) significantly predicted poor outcome. Preoperative @entity1640 grading was used in a prospective cohort of 22 @entity1 (mean age 8 years, mean follow-up period 1.2 years) treated between 2002 and 2004 to stratify @entity1 according to whether they underwent gross-total resection (GTR) (20%), complete resection avoiding the hypothalamus (40%), or subtotal resection (STR) (40%). In cases in which @entity66 was present, the @entity1 underwent radiotherapy. There have been no new cases of @entity86 , @entity5845 , or @entity146 in this prospective cohort. CONCLUSIONS: For many @entity1 with @entity976 , the cost of resection is @entity1640 and a poor QOL. By using a preoperative classification system to grade @entity1640 involvement and stratify treatment, the authors were able to minimize devastating morbidity. This was achieved by identifying subgroups in which complete resection or STR, performed by an experienced @entity976 surgeon and with postoperative radiotherapy when necessary, yielded better overall results than the traditional GTR.

@entity976 : classification and treatment according to the degree of XXXX involvement.

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient'] @entity66 :: ('MESH:D004194', 'Disease') :: ['residual disease'] @entity1640 :: ('MESH:D007027', 'Disease') :: ['hypothalamic dysfunction', 'hypothalamic'] @entity146 :: ('MESH:D001523', 'Disease') :: ['behavioral dysfunction'] @entity5845 :: ('MESH:D009767', 'Disease') :: ['morbid obesity'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative hyperphagia'] @entity976 :: ('MESH:D003397', 'Disease') :: ['craniopharyngiomas', 'craniopharyngioma']
@entity1640 :: (MESH:D007027,Disease) :: ['hypothalamic']
