颅咽管瘤
医学
儿科
放射治疗
外科
尿崩症
队列
内科学
作者
Mark Wijnen,Marry M. van den Heuvel‐Eibrink,Joseph A M J L Janssen,Coriene E. Catsman‐Berrevoets,Erna Michiels,M.L.C. van Veelen,A.H.G. Dallenga,J Berge,Caroline M. van Rij,Aart-Jan van der Lely,Sebastian J C M M Neggers
出处
期刊:European journal of endocrinology
[Bioscientifica]
日期:2017-06-01
卷期号:176 (6): 755-767
被引量:76
摘要
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. Design 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), and 90 Yttrium 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.
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