Clinical Situation, Therapy, and Follow-Up of Adult Craniopharyngioma

TY - JOUR

T1 - Clinical Situation, Therapy, and Follow-Up of Adult Craniopharyngioma

T2 - Report from the German Craniopharyngioma Registry

AU - Mende, Klaus Christian

AU - Kellner, Teresa

AU - Petersenn, Stephan

AU - Honegger, Juergen

AU - Evangelista-Zamora, Rocío

AU - Droste, Michael

AU - Stalla, Guenter

AU - Deutschbein, Timo

AU - Wang, Yawen

AU - Moskopp, Dag

AU - Knappe, Ulrich

AU - Schilbach, Katharina

AU - Flitsch, Joerg

N1 - © Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - CONTEXT: Craniopharyngioma is a rare neoplastic entity of the central nervous system. Childhood-onset craniopharyngioma is the subject of frequent research whereas the information on adult-onset craniopharyngioma is scarce.OBJECTIVE: The objective of this study was to examine the level of daily impairment in adult patients suffering from craniopharyngioma.DESIGN: Noninterventional patient registry indexed as PV4842 with the local ethics committee.SETTING: The study is set in a hospitalized and ambulatory setting.PATIENTS: 148 patients with adult-onset craniopharyngioma were recruited from 8 centers, 22 prospectively and 126 retrospectively. Mean follow-up was 31 months.INTERVENTIONS: No interventions performed.MAIN OUTCOME MEASURES: Complications, symptoms, body mass index (BMI), and quality of life (QoL; EORTC QLQ C30 and BN20) were recorded preoperatively and at follow-up. The hypotheses tested were generated after data collection.RESULTS: Complications were more frequent after transcranial than transsphenoidal approaches (31 % vs. 11%; P < 0.01). Preoperative obesity was present in 0% papillary and in 38% of all adamantinomatous craniopharyngiomas (P = 0.05), and diabetes insipidus was more frequent for papillary craniopharyngioma (36.8% vs. 16,7%; P < 0.05). Hormone deficits at follow-up were reduced in 16.9%, equal in 31.4%, and increased in 63.6% (P < 0.001). BMI increased from 28.7 ± 7.4 kg/m2 before surgery to 30.2 ± 7.4 kg/m2 at follow-up (P < 0.001). In QoL, a decrease of future uncertainty (62.5 vs. 36.8; P = 0.02) and visual disorders (38.9 vs. 12.0; P = 0.01) were observed in the prospective collective after surgery.CONCLUSIONS: Adult craniopharyngioma is associated with a complex sociological and psychological burden and hypothalamic dysfunction, warranting further investigation and emphasizing the need for a wider treatment approach.

AB - CONTEXT: Craniopharyngioma is a rare neoplastic entity of the central nervous system. Childhood-onset craniopharyngioma is the subject of frequent research whereas the information on adult-onset craniopharyngioma is scarce.OBJECTIVE: The objective of this study was to examine the level of daily impairment in adult patients suffering from craniopharyngioma.DESIGN: Noninterventional patient registry indexed as PV4842 with the local ethics committee.SETTING: The study is set in a hospitalized and ambulatory setting.PATIENTS: 148 patients with adult-onset craniopharyngioma were recruited from 8 centers, 22 prospectively and 126 retrospectively. Mean follow-up was 31 months.INTERVENTIONS: No interventions performed.MAIN OUTCOME MEASURES: Complications, symptoms, body mass index (BMI), and quality of life (QoL; EORTC QLQ C30 and BN20) were recorded preoperatively and at follow-up. The hypotheses tested were generated after data collection.RESULTS: Complications were more frequent after transcranial than transsphenoidal approaches (31 % vs. 11%; P < 0.01). Preoperative obesity was present in 0% papillary and in 38% of all adamantinomatous craniopharyngiomas (P = 0.05), and diabetes insipidus was more frequent for papillary craniopharyngioma (36.8% vs. 16,7%; P < 0.05). Hormone deficits at follow-up were reduced in 16.9%, equal in 31.4%, and increased in 63.6% (P < 0.001). BMI increased from 28.7 ± 7.4 kg/m2 before surgery to 30.2 ± 7.4 kg/m2 at follow-up (P < 0.001). In QoL, a decrease of future uncertainty (62.5 vs. 36.8; P = 0.02) and visual disorders (38.9 vs. 12.0; P = 0.01) were observed in the prospective collective after surgery.CONCLUSIONS: Adult craniopharyngioma is associated with a complex sociological and psychological burden and hypothalamic dysfunction, warranting further investigation and emphasizing the need for a wider treatment approach.

U2 - 10.1210/clinem/dgz043

DO - 10.1210/clinem/dgz043

M3 - SCORING: Journal article

C2 - 31589293

VL - 105

JO - J CLIN ENDOCR METAB

JF - J CLIN ENDOCR METAB

SN - 0021-972X

IS - 1

ER -