A ten-year follow-up study of treatment outcome of craniopharyngiomas.

Andereggen, Lukas; Hess, Benjamin; Andres, Robert; El-Koussy, Marwan; Mariani, Luigi; Raabe, Andreas; Seiler, Rolf; Christ, Emanuel (2018). A ten-year follow-up study of treatment outcome of craniopharyngiomas. Swiss medical weekly, 148(w14521), w14521. EMH Schweizerischer Ärzteverlag 10.4414/smw.2018.14521

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PURPOSE Craniopharyngioma-related hypothalamic obesity is a devastating complication with limited data on whether long-term follow-up should focus on problems other than endocrine deficiencies and weight gain. The primary endpoint was the assessment of predictors of hypothalamic obesity development; the secondary endpoint was the assessment of functional outcome (endocrine deficiencies, visual acuity) at long-term follow-up. METHODS This retrospective case-note study examined craniopharyngioma patients with at least 2 years of follow-up. Clinical, radiological and biochemical characteristics were assessed at diagnosis, postoperatively, and at last follow-up. RESULTS Thirty-two patients met the inclusion criteria. Median follow-up period was 9.8 years (range 2.2-33 years). Longitudinal changes in body mass index (BMI) were substantial (median ΔBMI/year was +0.48 kg/m2/year, interquartile range 0.28-1.33). The prevalence of patients with hypothalamic obesity had significantly increased at last follow-up (45 vs 4%; p = 0.003). Long-term pituitary deficiencies remained high. Diabetes insipidus was common (66% vs 34%, p<0.001), with postoperative diabetes insipidus but not hypothalamic involvement, being an independent predictor for hypothalamic obesity (odds ratio 15.2, 95% confidence interval 1.3-174.8, p = 0.03). Osteodensitometry in two thirds of patients at last follow-up revealed a pathological bone density in 53% of those tested. CONCLUSIONS Rates of hypothalamic obesity and long-term pituitary deficiencies are substantial, with postoperative diabetes insipidus being a potential marker for hypothalamic obesity development. Besides long-term monitoring of endocrine deficiencies with consideration of osteodensitometry, early weight control programmes and continuing multidisciplinary care are mandatory in craniopharyngioma patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Andereggen, Lukas; Andres, Robert; El-Koussy, Marwan; Mariani, Luigi; Raabe, Andreas; Seiler, Rolf and Christ, Emanuel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

02 Mar 2018 16:14

Last Modified:

04 Mar 2018 02:22

Publisher DOI:

10.4414/smw.2018.14521

PubMed ID:

29442342

BORIS DOI:

10.7892/boris.112073

URI:

https://boris.unibe.ch/id/eprint/112073

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