Quality of Life and Clinical Features of Long-Term Survivors Surgically Treated for Pediatric Craniopharyngioma.
OBJECTIVE
Several studies have reported treatment methods and results for pediatric craniopharyngiomas; however, few have evaluated patients' quality of life (QOL) after long-term follow-up. To evaluate treatment options, we assessed the QOL of patients with pediatric craniopharyngioma approximately 19 years after surgery and analyzed factors affecting QOL.


METHODS
Twenty-six survivors who underwent resection of craniopharyngiomas at <15 years of age enrolled in this study and their physical condition was assessed. QOL was assessed by a short-form health survey (SF-36 version 2) for patients older than 19 years of age or by Child Health Questionnaire Parent Form-50 for patients 18 years of age and younger. Patients were divided into good and fair QOL groups according to their physical and mental summary scores. Factors affecting the QOL of both groups were evaluated.


RESULTS
Median follow-up time was 19.1 years (range, 2.8-44.1 years). Twenty-two (84.6%) patients were employed or in school; 14 (53.8%) had visual deficits. Panhypopituitarism was diagnosed in 22 of 26 (84.6%) subjects. SF-36 analysis indicated that patients had significantly lower scores for general and mental health. Visual deficits, obesity, and complications during follow-up significantly affected the fair QOL group long-term. Patients' basic characteristics, initial resection rates, times of operation or irradiation did not significantly affect long-term QOL.


CONCLUSIONS
Long-term survivors lived independently but had a lower overall QOL. Not only monitor short-term results based on estimation of the initial resection or recurrence rate, it is important to preserve visual and hypothalamic function and monitor arising complications for extended periods to improve patients' long-term QOL.
Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University Graduate School, Kumamota, Japan. Electronic address: yanos@kumamoto-u.ac.jp.
Shigetoshi
S
Yano
Department of Neurosurgery, Hitoyoshi Medical Center, Kumamoto, Japan.
Mareina
M
Kudo
Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University Graduate School, Kumamota, Japan.
Takuichiro
T
Hide
Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University Graduate School, Kumamota, Japan.
Naoki
N
Shinojima
Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University Graduate School, Kumamota, Japan.
Keishi
K
Makino
Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University Graduate School, Kumamota, Japan.
Hideo
H
Nakamura
Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University Graduate School, Kumamota, Japan.
Jun-Ichi
J
Kuratsu
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003397:Craniopharyngioma / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007016:Hypophysectomy / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult
Craniopharyngioma; Long-term follow-up; Pediatrics; Quality of life