Extent of Resection and BMI Change after Endoscopic Craniopharyngioma Surgery: A Combined Adult-Pediatric Cohort

Introduction: The impact of surgical extent on tumor control and postoperative body mass index (BMI) change in patients with craniopharyngioma is unclear across ages. Prior studies suggest that greater surgical extent can result in greater postoperative weight gain in such patients, and that approaches designed to spare the hypothalamus reduce this risk without clearly compromising tumor control. We combined adult and pediatric endoscopic cases to evaluate oncologic and vision outcomes and BMI change using multiple complementary metrics. Objective: To compare tumor control and BMI change across management strategies in adult and pediatric patients with craniopharyngioma. Methods: This was a single-institution retrospective cohort of 49 purely endoscopic cases treated from 2007 to 2024 (33 adults and 16 children). Gross total resection (GTR) was defined as 100% radiographic resection. Incomplete resections combined near-total (>95%), subtotal (90–95%), partial (