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Show Poster 342 Visual and Oculomotor Outcomes in Children with Craniopharyngiomas by Initial Treatment Modality Kristy Yoo 1, Peter Chiarelli 2, Soniya Pinto 3, Benita Tamrazi 2, Mark Borchert 2, Melinda Chang 2 Keck School of Medicine of USC, 2 Children's Hospital of Los Angeles, Keck SOM of USC, 3 St. Jude Children’s Research Hospital 1 Introduction: Craniopharyngiomas account for approximately 4% of pediatric brain tumors in the United States. Treatment is primarily surgical, either gross total resection (GTR) or subtotal resection (STR). Adjuvant radiation therapy for patients with STR (STR+RT) may improve survival while reducing systemic morbidity. However, data are scarce regarding visual and oculomotor outcomes by treatment modality in children with craniopharyngiomas. Methods: We performed a retrospective chart review of children with craniopharyngiomas evaluated at our institution between 2011 and 2021. Final best-corrected visual acuity (BCVA) in the better-seeing eye was compared among treatment groups (GTR, STR, and STR+RT) using a generalized linear regression model to adjust for follow-up time and baseline demographics. Cox proportional hazard regression was used to compare groups on rates of progression-free survival (PFS), cranial nerves III, IV, and VI palsy (CN palsy), visual field defects (VFD), and optic atrophy (OA). Results: We included 43 children with an average age at diagnosis of 7.8±3.7 years and follow-up time of 6.9±4.6 years. Initial treatment was GTR in 16 (37%) patients, STR in 7 (16%), and STR+RT in 20 (47%). Mean final BCVA in logMAR was 0.62±0.58 in the GTR group, which was significantly worse than the STR (0.11±0.17 , p=0.001) and STR+RT (0.36±0.53, p=0.02) groups. Overall, at last follow-up, 35 (81%) patients experienced VFD, 9 (21%) had at least one CN palsy, and 36 (84%) developed OA, with no significant differences between groups (p > 0.12). Patients undergoing GTR had a 5-year PFS rate of 63%, which was significantly better than 43% in STR group (HR=5.46; p=0.030) and 30% in the STR+RT group (HR=5.59; p=0.01). Conclusions: Children with craniopharyngiomas who underwent GTR had worse final BCVA but higher progression-free survival compared to those initially treated with STR with or without RT. Clinicians should counsel families accordingly when discussing treatment options. References: None provided. Keywords: Pediatric neuro-ophthalmology, Tumors Financial Disclosures: The authors had no disclosures. Grant Support: NIH NEI 1K23EY033790-01 Contact Information: None provided. 532 | North American Neuro-Ophthalmology Society |
