Clinical Situation, Therapy, and Follow-Up of Adult Craniopharyngioma Report from the German Craniopharyngioma Registry

Mende, Klaus Christian; Kellner, Teresa; Petersenn, Stephan; Honegger, Jürgen; Evangelista-Zamora, Rocio; Droste, Michael; Stalla, Guenter; Deutschbein, Timo; Wang, Yawen; Moskopp, Dag; Knappe, Ulrich; Schilbach, Katharina und Flitsch, Jörg (2020): Clinical Situation, Therapy, and Follow-Up of Adult Craniopharyngioma Report from the German Craniopharyngioma Registry. In: Journal of Clinical Endocrinology & Metabolism, Bd. 105, Nr. 1: S. 252-265

Abstract

Context: Craniopharyngioma is a rare neoplastic entity of the central nervous system. Childhood-onset craniopharyngioma is the subject of frequent research whereas the information on adult-onset craniopharyngioma is scarce. Objective: The objective of this study was to examine the level of daily impairment in adult patients suffering from craniopharyngioma. Design: Noninterventional patient registry indexed as PV4842 with the local ethics committee. Setting: The study is set in a hospitalized and ambulatory setting. Patients: 148 patients with adult-onset craniopharyngioma were recruited from 8 centers, 22 prospectively and 126 retrospectively. Mean follow-up was 31 months. Interventions: No interventions performed. Main Outcome Measures: Complications, symptoms, body mass index (BMI), and quality of life (QoL;EORTC QLQ C30 and BN20) were recorded preoperatively and at follow-up. The hypotheses tested were generated after data collection. Results: Complications were more frequent after transcranial than transsphenoidal approaches (31 % vs. 11%;P < 0.01). Preoperative obesity was present in 0% papillary and in 38% of all adamantinomatous craniopharyngiomas (P = 0.05), and diabetes insipidus was more frequent for papillary craniopharyngioma (36.8% vs. 16,7%;P < 0.05). Hormone deficits at follow-up were reduced in 16.9%, equal in 31.4%, and increased in 63.6% (P < 0.001). BMI increased from 28.7 +/- 7.4 kg/m(2) before surgery to 30.2 +/- 7.4 kg/m(2) at follow-up (P < 0.001). In QoL, a decrease of future uncertainty (62.5 vs. 36.8;P = 0.02) and visual disorders (38.9 vs. 12.0;P = 0.01) were observed in the prospective collective after surgery. Conclusions: Adult craniopharyngioma is associated with a complex sociological and psychological burden and hypothalamic dysfunction, warranting further investigation and emphasizing the need for a wider treatment approach.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0021-972X
• Sprache: Englisch