Nordic survey on practice of neurosurgical management of craniopharyngioma in children

PURPOSE: Management of childhood-onset craniopharyngioma (CP) may be challenging, given its rarity and complexity as well as the risks associated with treatment. We aimed at investigating how the practice of neurosurgical management of CP in children differs among neurosurgical centres in Nordic countries.

METHODS: We performed a survey containing 28 questions and focusing on organization of care, expertise availability, treatment decisions and strategies, and follow-up routines, respectively. The survey was distributed to 21 neurosurgical centres in five Nordic countries.

RESULTS: We obtained answers from 18 centres (86% response rate). In 61% of centres, only 0-1 new cases are treated per year. In only one country (Denmark), the neurosurgical treatment of pediatric CP is centralized to one centre. While all cases are discussed at MDT meetings before surgery and during the follow-up, management strategies, including surgical indications, goals, and approaches, vary substantially among responding centres.

CONCLUSION: The practice of neurosurgical management of pediatric CP in the Nordic countries is characterized by relatively low case volumes, differing management strategies, as well as varying degrees of centralization and collaboration between pediatric and adult neurosurgeons. Although some practical aspects may be unique for healthcare practised in the Nordic countries, the results of this survey and, in particular, the embedded discussion of centralization - either restricted to surgery or including complete management of pediatric CP - seem relevant and may provide useful insights also to neurosurgeons outside of the Nordics.