2026 Proffered Presentations
S203: BENCHMARK SURGICAL OUTCOMES FOR ENDOSCOPIC TRANSNASAL CRANIOPHARYNGIOMA RESECTION: IMPLICATIONS FOR CLINICAL PRACTICE FROM THE RAPID CONSORTIUM
Sam Tenhoeve1; Cody Orton1; Diwas Gautam1; Julie M Silverstein, MD2; Albert H Kim, MD, PhD2; James J Evans, MD3; Garni Barkhoudarian, MD4; Juan C Fernandez-Miranda, MD5; Donato R Pacione, MD6; Won Kim, MD7; Marvin Bergsneider, MD7; Michael R Chicoine, MD8; Gabriel Zada, MD9; Varun R Kshetty, MD10; Kyle Wu, MD11; Carolina Benjamin, MD12; Jamie Van Gompel, MD13; Sandhya Palit, MBBS13; Michael P Catalino, MD14; Adam Mamelak, MD15; Nathan Zwagerman, MD16; Stephanie Cheok, MD16; Andrew S Little, MD17; Michelle Magana Mendoza, BS17; Georgios Zenonos, MD18; Paul Gardner, MD18; Michael Karsy, MD, PhD19; Ramin Morshed, MD20; Spiros Blackburn, MD21; Debraj Mukherjee, MD22; Andre Beer-Furlan, MD, PhD23; William T Couldwell, MD, PhD1; Robert C Rennert, MD1; 1University of Utah; 2Washington University School of Medicine; 3Jefferson University; 4Pacific Neuroscience Institute; 5Stanford University; 6New York University; 7University of California, Los Angeles; 8University of Missouri; 9University of Southern California; 10Cleveland Clinic Foundation; 11Ohio State University; 12University of Miami; 13Mayo Clinic; 14University of Virginia; 15Cedars-Sinai Medical Center; 16Medical College of Wisconsin; 17Barrow Neurological Institute; 18University of Pittsburgh Medical Center; 19University of Michigan; 20University of California, San Francisco; 21University of Texas Health; 22Johns Hopkins University; 23Moffitt Cancer Center
Objective: Craniopharyngiomas are intricate tumors within the skull that present major challenges during surgery, with a risk of complications, hospital readmission, and recurrence. To help compare results across hospitals and inform treatment decisions, the authors set benchmarks for surgical outcomes in patients who undergo endoscopic craniopharyngioma removal. They used data from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) database to examine factors like hospital stay, readmission rates, discharge to skilled nursing facilities, cerebrospinal fluid leaks, tumor recurrence, and endocrine issues.
Methods: A retrospective study across 14 U.S. academic centers using data from the RAPID registry, collected from 2011 to 2024, was conducted. The study analyzed patients with craniopharyngioma who underwent their first endoscopic transnasal surgery. Patients were divided into low-risk and high-risk groups based on factors like age, body mass index, whether the tumor invaded the ventricles, and prior radiation treatment. The researchers examined surgical outcomes and set benchmarking ranges using established methods.
Results: The overall group of patients included 356 individuals, with an average age of 46.0 years. To compare results, we analyzed 50th-75th percentile performance data. For low-risk patients (158 patients), the median length of stay was 4.5-6 days. Readmission rates within 90 days were 9.1-23.1%, and discharge to skilled nursing facilities was less than 1.0%. The rate of new postoperative cerebrospinal fluid leaks was 1.0-10.3%, and gross total resection rates were 50.0-60.9%. We also found that new postoperative arginine vasopressin deficiency rates were 50.0-60.4%, and tumor recurrence rates were less than 1.0-9.6% over 32 months of follow-up. To make it easier to compare results across institutions, we proposed ranges for each outcome.
Conclusions: Setting surgical outcome benchmarks for patients who undergo craniopharyngioma resection using RAPID data offers a framework for evaluating surgical performance and informing clinical decisions. These benchmark ranges can help guide institutional efforts to improve quality, assess perioperative risks, and counsel patients on expected postoperative outcomes.