P14.17.B A REAL-WORLD SURVEY OF 1830 SURVIVING PATIENTS WITH ADAMANTINOMATOUS CRANIOPHARYNGIOMA IN CHINA

Abstract BACKGROUND Adamantinomatous craniopharyngioma (ACP) is a rare benign tumor of the central nervous system. Real-world studies on surviving patients in China remain lacking. This study aimed to systematically analyze the demographic characteristics, treatment patterns, complications, recurrence rates, and factors influencing quality of life (QoL) and family economic burden among Chinese ACP survivors through an independent third-party survey. MATERIAL AND METHODS In July 2024, a third-party volunteer team conducted a questionnaire survey of 1,830 ACP survivors in Chinese communities. Chi-square tests and multivariate logistic regression analyses (SPSS 21.0) were used to evaluate influencing factors. RESULTS 72.3% of patients underwent initial surgery at ages 0-10 years, with a male predominance (59.3% vs. 40.7% female). In the initial treatment, 98.6% of patients underwent surgery. Gross total resection (GTR) rates were comparable between transcranial approach (TCA) (84.37%) and endoscopic endonasal surgery (EES) (87.73%), but TCA had significantly higher recurrence rates (26.1% vs. 15.3%; P<0.001) compared to EES. In subtotal resection cases, regrowth rates were higher after TCA (65.26% vs. 40.74% EES; P=0.0001). Among 267 patients with residual tumors, only 108 were recommended radiotherapy (RT), and 56 ultimately received RT. RT recipients required no further treatment significantly more often than non-RT cases (36/56 vs. 77/211; P=0.0002). Among patients with residual tumors after the first operation, only 108 were recommended for RT by doctors, and 56 eventually received it. The proportion of patients who did not require further treatment after radiotherapy was significantly higher than those who did not receive it (36/56 vs. 77/211, P=0.0002). There were differences in the incidence of complications between TCA and EES. Specifically, for gross total resection, TCA associated with higher rates of sinusitis, dyslipidemia, hyperglycemia, flatfoot, and forehead incision suppuration. For subtotal resection, EES was linked to increased incidences of hypothalamic obesity, diabetes insipidus, and scoliosis. The QoL was significantly affected by the type of surgery (TCA OR=0.393, P<0.001), absence of hypothalamic obesity (OR=0.541, P=0.001) and absence of recurrence (OR=1.923, P<0.001). Family economic burden was significantly associated with age at first operation (OR=1.020, P=0.001) and impaired QoL (mild OR=4.427, P<0.001; Moderate OR=1.825, P=0.017). CONCLUSION The treatment of ACP patients in China is predominantly centralized in experienced medical centers. EES offers advantages in reducing recurrence rate, and radiotherapy can provides substantial benefits to patients. TCA is significantly associated with decreased QoL. Therefore, it is necessary to optimize individualized treatment strategies and strengthen postoperative support.