Population-based histologic analysis of craniopharyngioma demographics and treatment in the US from 2000 to 2020.

Purpose: Craniopharyngiomas (CP) are rare tumors that serve as a source of significant morbidity despite relatively high survival rates. No analysis based on disease histology has been fully explored.

Methods: Patients with CP were identified via the Surveillance, Epidemiology, and End Results (SEER) Program regarding the following ICD-O-3 codes: 9350 (CP, not otherwise specified; NOS), 9351 (adamantinomatous CP; ACP), and 9352 (papillary CP; PCP). Demographic and treatment variables were analyzed via Chi-squared tests and ten-year overall survival (10y OS) was assessed via Cox regression and log-rank analysis.

Results: Variation in 10y OS was seen regarding patient age (p < 0.001), race (p < 0.001), Grade (p = 0.010), stage (p < 0.001), and treatment with radiotherapy (p < 0.001) with Cox regression analysis among the 2,359 patients identified. ACP or CP, NOS histologies were more frequent among patients < 25 years old (p < 0.001), while ACP was more common among male patients (p = 0.002) and PCP was less common among Black patients (p = 0.002). Univariate survival analysis revealed the ACP and CP, NOS histologies had improved 10y OS with treatment with radiotherapy (p < 0.001 and = 0.007, respectively). Finally, surgery was associated with improved 10y OS only among patients with the CP, NOS histology (p = 0.007).

Conclusion: No difference in 10-year overall survival was seen regarding histology among diagnosed with craniopharyngioma on multivariate or univariate analysis. Differences in the frequency and survival were found among all three histologies stratified by demographics and treatment. Further investigation into these variables, and among different survival timeframes, is warranted.