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Reply to: Understanding treatment options in craniopharyngioma better

Nature Reviews Disease Primers volume 6, Article number: 27 (2020) Cite this article

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On behalf of my coauthors of our recent Primer (Müller, H. L., Merchant, T. E., Warmuth-Metz, M., Martinez-Barbera, J. P. & Puget, S. Craniopharyngioma. Nat. Rev. Dis. Primers 5, 75 (2019))1, I would like to thank Prof. Dr Qi for his Correspondence (Qi, S. Understanding treatment options in craniopharyngioma better. Nat. Rev. Dis. Primers https://doi.org/10.1038/s41572-020-0173-1 (2020))2, which included the need to discuss some additional diagnostic and therapeutic considerations.

We agree and appreciate the valuable findings of Prof. Dr Qi on the anatomical relationship between craniopharyngioma and structures of the third ventricle, which definitely support and improve risk-adapted surgical approaches. On the basis of the results of multicentre studies using our grading system of preoperative hypothalamic involvement and surgical hypothalamic lesions3, we conclude that our classification of hypothalamic involvement and/or damage is feasible and provides valid risk prediction of hypothalamic syndrome and sequelae. Assessment of tumour location with regard to the mammillary bodies on preoperative MRI is recommended for planning of risk-adapted surgical approaches. More sophisticated classifications of hypothalamic location might better reflect the anatomical situation, but — based on our experience — they are not feasible for general use in a multicentre setting, owing to frequently insufficient technical quality of imaging procedures and the lack of standardization.

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References

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Authors and Affiliations

  1. Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Klinikum Oldenburg AöR, Oldenburg, Germany

    Hermann L. Müller

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  1. Hermann L. Müller
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Correspondence to Hermann L. Müller.

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Competing interests

H.L.M. has received reimbursement of participation fees for scientific meetings and continuing medical education events from the following companies: Ferring, Lilly, Pfizer, Sandoz/Hexal, Novo Nordisk, Ipsen and Merck Serono. He has received reimbursement of travel expenses from Ipsen and lecture honoraria from Pfizer.

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Müller, H.L. Reply to: Understanding treatment options in craniopharyngioma better. Nat Rev Dis Primers 6, 27 (2020). https://doi.org/10.1038/s41572-020-0174-0

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