Very long-Term sequelae of craniopharyngioma
Objective: Studies investigating long-Term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-Term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-Term health conditions between patients with childhood-And adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-Term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Design: Cross-sectional study based on retrospective data. Methods: We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5-23 years). Initial craniopharyngioma treatment approaches included gross total resection (n = 25), subtotal resection without radiotherapy (n = 44), subtotal resection with radiotherapy (n = 25), cyst aspiration without radiotherapy (n = 8), and 90Yttrium brachytherapy (n = 21). Results: Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-Term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-Term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood-And adult-onset craniopharyngioma. Conclusions: Long-Term health conditions were comparable after different initial craniopharyngioma treatment approaches and were generally more frequent in patients with childhood- compared with adult-onset disease.
|Persistent URL||dx.doi.org/10.1530/EJE-17-0044, hdl.handle.net/1765/101705|
|Journal||European Journal of Endocrinology|
Wijnen, M. (Mark), van den Heuvel-Eibrink, M.M, Janssen, J.A.M.J.L, Catsman-Berrevoets, C.E, Michiels, E.M.C, van Veelen-Vincent, M.L.C, … Neggers, S.J.C.M.M. (2017). Very long-Term sequelae of craniopharyngioma. European Journal of Endocrinology, 176(6), 755–767. doi:10.1530/EJE-17-0044