title: [Childhood craniopharyngioma with hypothalamic obesity - no long-term weight reduction due to rehabilitation programs].
abstract: BACKGROUND
  Severe obesity due to hypothalamic involvement has major impact on prognosis in long-term survivors of childhood craniopharyngioma. The long-term effects of rehabilitation efforts on weight development and obesity in these patients are not analyzed up to now.
  
  
  METHODS
  108 patients with childhood craniopharyngioma recruited in HIT Endo before 2001 were included in the study. Long-term weight development (BMI SDS after >10 yrs follow-up) was analyzed in regard to rehabilitation, which was performed in 31 of 108 (29%) patients (one rehabilitation in 4 patients (13%), more than one in 21 patients (68%), 6 patients unknown) in 13 German rehabilitation -clinics.
  
  
  RESULTS
  84% of patients underwent rehabilitation in order to reduce hypothalamic obesity (BMI>+ 2 SD), whereas 12% of patients were normal weight. Childhood craniopharyngioma pa-tients with rehabilitation presented with higher BMI at diagnosis (median BMI: +1.32 SD; range: -1.08 to + 7.00 SD) and at last evaluation (median BMI: +4.93 SD; range: -0.20 to + 13.13 SD) when compared with patients without rehabilitation (median BMI at diagnosis: +0.24 SD; range: -2.67 to + 6.98 SD; BMI at evaluation: +2.09 SD; range: -1.48 to + 10.23 SD). A long-term weight reducing effect of rehabilitation was no detectable regardless of degree of obesity, frequency of rehabilitation, and hospital of rehabilitation.
  
  
  CONCLUSIONS
  Treatment options for hypothalamic obesity in terms of rehabilitation are limited. Accordingly, strategies for prevention of hypothalamic lesions and psychosocial effects of rehabilitation are currently in focus for improvement of prognosis in childhood craniopharyngioma patients.
authors.affiliation: University Medical Center (UMCG), University of Groningen, Groningen, Netherlands.
authors.forename: A S
authors.initials: AS
authors.lastname: Sterkenburg
authors.affiliation: Klinik für Allgemeine Kinderheilkunde, Hämatologie/Onkologie, Zentrum für Kinder- und Jugendmedizin, Klinikum Oldenburg, Medizinischer Campus Universität Oldenburg, Oldenburg.
authors.forename: A
authors.initials: A
authors.lastname: Hoffmann
authors.affiliation: Klinik für Allgemeine Kinderheilkunde, Hämatologie/Onkologie, Zentrum für Kinder- und Jugendmedizin, Klinikum Oldenburg, Medizinischer Campus Universität Oldenburg, Oldenburg.
authors.forename: U
authors.initials: U
authors.lastname: Gebhardt
authors.affiliation: Edelsteinklinik, Fachklinik für Kinder- und Jugendrehabilitation, Bruchweiler.
authors.forename: E
authors.initials: E
authors.lastname: Waldeck
authors.affiliation: Klinik Hochried, Zentrum für Kinder, Jugendliche und Familien, Murnau.
authors.forename: S
authors.initials: S
authors.lastname: Springer
authors.affiliation: Klinik für Allgemeine Kinderheilkunde, Hämatologie/Onkologie, Zentrum für Kinder- und Jugendmedizin, Klinikum Oldenburg, Medizinischer Campus Universität Oldenburg, Oldenburg.
authors.forename: H L
authors.initials: HL
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003397:Craniopharyngioma / Q000150:complications* / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000150:complications* / Q000534:rehabilitation*; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009765:Obesity / Q000209:etiology* / Q000534:rehabilitation*; D010343:Patient Admission; D010911:Pituitary Neoplasms / Q000150:complications* / Q000534:rehabilitation; D011788:Quality of Life; D012047:Rehabilitation Centers; D015431:Weight Loss