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.


METHODS
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), and90Yttrium 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.
Section EndocrinologyDepartment of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, the Netherlands.|Department of Paediatric Oncology/HaematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.
Mark
M
Wijnen
Department of Paediatric Oncology/HaematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.|Princess Maxima Centre for Paediatric OncologyUtrecht, the Netherlands.
Marry M
MM
van den Heuvel-Eibrink
Section EndocrinologyDepartment of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Joseph A M J L
JAMJL
Janssen
Department of Paediatric Neurology.
Coriene E
CE
Catsman-Berrevoets
Department of Paediatric Oncology/HaematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.
Erna M C
EMC
Michiels
Department of Paediatric NeurosurgeryErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.
Marie-Lise C
MC
van Veelen-Vincent
Department of Neurosurgery.
Alof H G
AHG
Dallenga
Department of Neurosurgery.
J Herbert
JH
van den Berge
Department of Radiation OncologyPituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Carolien M
CM
van Rij
Section EndocrinologyDepartment of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Aart-Jan
AJ
van der Lely
Section EndocrinologyDepartment of Medicine, Pituitary Centre Rotterdam, Erasmus University Medical Centre, Rotterdam, the Netherlands.|Department of Paediatric Oncology/HaematologyErasmus MC - Sophia Children's Hospital, Rotterdam, the Netherlands.
Sebastian J C M M
SJCMM
Neggers
D017668:Age of Onset; D000375:Aging; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000009:adverse effects; D003397:Craniopharyngioma / Q000150:complications / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D010911:Pituitary Neoplasms / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D016019:Survival Analysis; D014786:Vision Disorders / Q000453:epidemiology / Q000209:etiology*