title: Hydrocephalus and hypothalamic involvement in pediatric patients with craniopharyngioma or cysts of Rathke's pouch: impact on long-term prognosis.
abstract: OBJECTIVE
  Pediatric patients with sellar masses such as craniopharyngioma (CP) or cyst of Rathke's pouch (CRP) frequently suffer disease- and treatment-related sequelae. We analyzed the impact and prognostic relevance of initial hydrocephalus (HY) and hypothalamic involvement (HI) on long-term survival and functional capacity (FC) in children with CP or CRP.
  
  
  METHODS
  Using retrospective analysis of patient records, presence of initial HY or HI was assessed in 177 pediatric patients (163 CP and 14 CRP). Twenty-year overall survival (OS) and progression-free survival (PFS), FC, and BMI were analyzed with regard to initial HY, degree of resection, or HI.
  
  
  RESULTS
  Of the 177 patients, 105 patients (103/163 CP and 2/14 CRP) presented with initial HY and 96 presented with HI. HY at diagnosis was associated (P=0.000) with papilledema, neurological deficits, and higher BMI at diagnosis and during follow-up. OS, PFS, and FC were not affected by HY at initial diagnosis. HI at diagnosis (96/177) had major negative impact on long-term prognosis. Sellar masses with HI were associated with lower OS (0.84±0.04; P=0.021), lower FC (P=0.003), and higher BMI at diagnosis and last follow-up (P=0.000) when compared with sellar masses without HI (OS: 0.94±0.05). PFS was not affected by HI or degree of resection.
  
  
  CONCLUSIONS
  Initial HY has no impact on outcome in patients with sellar masses. OS and FC are impaired in survivors presenting with initial HI. PFS is not affected by HY, HI, or degree of resection. Accordingly, gross-total resection is not recommended in sellar masses with initial HI to prevent further hypothalamic damage.
authors: Department of PediatricsKlinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133 Oldenburg, GermanyUniversity of GroningenGroningen, The NetherlandsDepartment of NeuroradiologyUniversity Hospital, Würzburg, Germany Department of PediatricsKlinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133 Oldenburg, GermanyUniversity of GroningenGroningen, The NetherlandsDepartment of NeuroradiologyUniversity Hospital, Würzburg, Germany.
authors: A M M
authors: AM
authors: Daubenbüchel
authors: Department of PediatricsKlinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133 Oldenburg, GermanyUniversity of GroningenGroningen, The NetherlandsDepartment of NeuroradiologyUniversity Hospital, Würzburg, Germany.
authors: A
authors: A
authors: Hoffmann
authors: Department of PediatricsKlinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133 Oldenburg, GermanyUniversity of GroningenGroningen, The NetherlandsDepartment of NeuroradiologyUniversity Hospital, Würzburg, Germany.
authors: U
authors: U
authors: Gebhardt
authors: Department of PediatricsKlinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133 Oldenburg, GermanyUniversity of GroningenGroningen, The NetherlandsDepartment of NeuroradiologyUniversity Hospital, Würzburg, Germany.
authors: M
authors: M
authors: Warmuth-Metz
authors: Department of PediatricsKlinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133 Oldenburg, GermanyUniversity of GroningenGroningen, The NetherlandsDepartment of NeuroradiologyUniversity Hospital, Würzburg, Germany Department of PediatricsKlinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133 Oldenburg, GermanyUniversity of GroningenGroningen, The NetherlandsDepartment of NeuroradiologyUniversity Hospital, Würzburg, Germany.
authors: A S
authors: AS
authors: Sterkenburg
authors: Department of PediatricsKlinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133 Oldenburg, GermanyUniversity of GroningenGroningen, The NetherlandsDepartment of NeuroradiologyUniversity Hospital, Würzburg, Germany mueller.hermann@klinikum-oldenburg.de.
authors: H L
authors: HL
authors: Müller
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D001827:Body Height; D020863:Central Nervous System Cysts / Q000150:complications* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003397:Craniopharyngioma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology* / Q000473:pathology; D007027:Hypothalamic Diseases / Q000209:etiology* / Q000473:pathology; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010911:Pituitary Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D016019:Survival Analysis; D017741:Survivors; D016896:Treatment Outcome; D055815:Young Adult