2585 - Association of Treatment Modality with Net Survival and Cause-Specific Excess Mortality in Craniopharyngioma: A Population-Based Analysis in the Modern Radiotherapy Era

08:00am - 09:00am PT

Hall F

Screen: 1

POSTER

Presenter(s)

Zi Du, MBBS - Chinese Academy of Medical Sciences Cancer Institute and Hospital: Cancer Hospital Chinese Academy of Medical Sciences, Beijing, Beijing

Z. O. Du¹, Y. Wu¹, T. Wu², S. Qi¹, and Y. X. Li¹; ¹Chinese Academy of Medical Sciences Cancer Institute and Hospital: Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China, ²Guizhou Cancer Hospital, Guiyang, China

Purpose/Objective(s): Craniopharyngioma is a rare benign brain tumor with high survival rates but increased mortality risks due to recurrence and treatment complications. This study aimed to analyze the association of different primary treatment strategies with long-term net survival and cause-specific excess mortality in the modern radiotherapy era.

Materials/Methods: 2,352 patients with craniopharyngioma were selected and analyzed from Surveillance, Epidemiology, and End Results (SEER) database (2000–2019). Inverse probability of treatment weighting was conducted to balance the baseline characteristics among treatments. The standardized mortality ratio (SMR), relative survival (RS) adjusted for background mortality of the general population were used as primary endpoints to compare the net survival and cause-specific excess mortality between treatments.

Results: Compared to the general population, patients exhibited a 4.9-fold increased mortality risk, driven by both tumor-related (SMR=7.0) and non-tumor causes (SMR=3.6). Although different surgery choices showed comparable RS (10-year RS: non-surgery 73.5%, STR 78.0%, GTR 78.8%; P=0.257), GTR was associated with lower mortality risks from benign tumor, infections and cardiovascular diseases. Radiotherapy combined with STR significantly improved RS (84.5% vs. 75.6%, P=0.002) without increased non-tumor-related excess mortality. However, adding radiotherapy to GTR increased cerebrovascular disease-related mortality (SMR=23.5 vs. 4.2, P=0.046; EAR=5.64 vs. 1.24) without improving RS.

Conclusion: Treatment strategies significantly influence both tumor-related and non-tumor-related mortality in craniopharyngioma patients. Radiotherapy significantly improved net survival in STR patients rather than GTR patients without increasing non-tumor excess mortality in the modern therapy era.