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An analysis of clinical characteristics and postoperative complications in children craniopharyngioma

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Abstract

Objective

Children treated for craniopharyngioma (CP) experience significant morbidity. We aimed to investigate the clinical characteristics and postoperative complications of pediatric CP and to determine risk factors for complications to provide a theoretical basis for postoperative treatment.

Methods

In this retrospective analysis, we screened clinical data concerning children with CP who had undergone surgery at our hospital from December 2011 to June 2015. We statistically analyzed the relationship between age, sex, disease course, tumor location, extent of tumor resection, and neuroendocrine axis dysfunction.

Results

Of 240 patients (males, n = 144; females, n = 96; mean age, 8.33 ± 4.64 years), the main clinical presentations were headache (n = 151, 62.92%), vomiting (n = 84, 35%), vision changes (n = 101, 42.08%), polydipsia and polyuria (n = 47, 19.58%), and growth retardation (n = 42, 17.5%). Hypothalamic-pituitary dysfunction was the most common postoperative complication. There were 216 (90.00%) and 181 (75.42%) patients with pituitary-thyroid and pituitary-adrenal axis injuries, respectively. Being a prepubescent girl was a risk factor for impaired pituitary-thyroid and pituitary-adrenal axis function (P < 0.05). No correlation was found between sex (male), age, disease course, tumor location, extent of tumor resection, and impaired pituitary-thyroid and pituitary-adrenal axis function (P > 0.05). Pituitary-gonad axis injury was observed in 91 (37.92%) patients. Saddle and suprasellar region tumors were risk factors for impaired pituitary-gonad axis function (P < 0.05). No statistically significant correlation was found between sex, disease course, extent of resection, and impaired pituitary-gonad axis function (P > 0.05).

Conclusions

Routine screening for complications during treatment is indicated for children with CP, to optimize the timing of interventions and reduce long-term morbidity.

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References

  1. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM (1998) The descriptive epidemiology of craniopharyngioma. J Neurosurg 89:547–551

    Article  CAS  Google Scholar 

  2. Nielsen EH, Feldt-Rasmussen U, Poulsgaard L, Kristensen LO, Astrup J, Jorgensen JO et al (2011) Incidence of craniopharyngioma in Denmark (n = 189) and estimated world incidence of craniopharyngioma in children and adults. J Neurooncol 104:755–763

    Article  CAS  Google Scholar 

  3. Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C et al (2017) Cbtrus statistical report: primary brain and other central nervous system tumors diagnosed in the united states in 2010–2014. Neuro Oncol 19:v1–v88

    Article  Google Scholar 

  4. Jensterle M, Jazbinsek S, Bosnjak R, Popovic M, Zaletel LZ, Vesnaver TV et al (2019) Advances in the management of craniopharyngioma in children and adults. Radiol Oncol 53:388–396

    Article  Google Scholar 

  5. Bogusz A, Muller HL (2018) Childhood-onset craniopharyngioma: latest insights into pathology, diagnostics, treatment, and follow-up. Expert Rev Neurother 18:793–806

    Article  CAS  Google Scholar 

  6. Rickert CH, Paulus W (2001) Epidemiology of central nervous system tumors in childhood and adolescence based on the new who classification. Child’s nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 17:503–511

    Article  CAS  Google Scholar 

  7. Cheng J, Fan Y, Cen B (2017) Effect of preserving the pituitary stalk during resection of craniopharyngioma in children on the diabetes insipidus and relapse rates and long-term outcomes. J Craniofac Surg 28:e591–e595

    Article  Google Scholar 

  8. Cheng J, Shao Q, Pan Z, You J (2016) Analysis and long-term follow-up of the surgical treatment of children with craniopharyngioma. J Craniofac Surg 27:e763–e766

    Article  Google Scholar 

  9. Muller HL (2010) Childhood craniopharyngioma–current concepts in diagnosis, therapy and follow-up. Nat Rev Endocrinol 6:609–618

    Article  Google Scholar 

  10. Hoffmann A, Boekhoff S, Gebhardt U, Sterkenburg AS, Daubenbuchel AM, Eveslage M et al (2015) History before diagnosis in childhood craniopharyngioma: associations with initial presentation and long-term prognosis. Eur J Endocrinol 173:853–862

    Article  CAS  Google Scholar 

  11. Mortini P, Losa M, Pozzobon G, Barzaghi R, Riva M, Acerno S et al (2011) Neurosurgical treatment of craniopharyngioma in adults and children: early and long-term results in a large case series. J Neurosurg 114:1350–1359

    Article  Google Scholar 

  12. Wijnen M, van den Heuvel-Eibrink MM, Janssen J, Catsman-Berrevoets CE, Michiels EMC, van Veelen-Vincent MC et al (2017) Very long-term sequelae of craniopharyngioma. Eur J Endocrinol 176:755–767

    Article  CAS  Google Scholar 

  13. Tan TSE, Patel L, Gopal-Kothandapani JS, Ehtisham S, Ikazoboh EC, Hayward R et al (2017) The neuroendocrine sequelae of paediatric craniopharyngioma: a 40-year meta-data analysis of 185 cases from three uk centres. Eur J Endocrinol 176:359–369

    Article  CAS  Google Scholar 

  14. Puget S, Garnett M, Wray A, Grill J, Habrand JL, Bodaert N et al (2007) Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg 106:3–12

    PubMed  Google Scholar 

  15. Boekhoff S, Bogusz A, Sterkenburg AS, Eveslage M, Muller HL (2018) Long-term effects of growth hormone replacement therapy in childhood-onset craniopharyngioma: results of the german craniopharyngioma registry (hit-endo). Eur J Endocrinol 179:331–341

    Article  CAS  Google Scholar 

  16. Muller HL (2017) Diagnosis, treatment, clinical course, and prognosis of childhood-onset craniopharyngioma patients. Minerva Endocrinol 42:356–375

    Article  Google Scholar 

  17. Sun F, Sun X, Du X, Xing H, Yang B (2017) Factors related to endocrine changes and hormone substitution treatment during pre- and post-operation stages in craniopharyngioma. Oncol Lett 13:250–252

    Article  CAS  Google Scholar 

  18. Kendall-Taylor P, Jonsson PJ, Abs R, Erfurth EM, Koltowska-Haggstrom M, Price DA et al (2005) The clinical, metabolic and endocrine features and the quality of life in adults with childhood-onset craniopharyngioma compared with adult-onset craniopharyngioma. Eur J Endocrinol 152:557–567

    Article  CAS  Google Scholar 

  19. Muller HL, Merchant TE, Puget S, Martinez-Barbera JP (2017) New outlook on the diagnosis, treatment and follow-up of childhood-onset craniopharyngioma. Nat Rev Endocrinol 13:299–312

    Article  Google Scholar 

  20. Chen JX, Alkire BC, Lam AC, Curry WT, Holbrook EH (2016) Aseptic meningitis with craniopharyngioma resection: consideration after endoscopic surgery. J Neurol Surg Rep 77:e151–e155

    Article  Google Scholar 

  21. Steno J (1985) Microsurgical topography of craniopharyngiomas. Acta Neurochir Suppl 35:94–100

    Article  CAS  Google Scholar 

  22. Yasargil MG, Curcic M, Kis M, Siegenthaler G, Teddy PJ, Roth P (1990) Total removal of craniopharyngiomas. Approaches and long-term results in 144 patients. J Neurosurg 73:3–11

  23. Pascual JM, Gonzalez-Llanos F, Barrios L, Roda JM (2004) Intraventricular craniopharyngiomas: topographical classification and surgical approach selection based on an extensive overview. Acta Neurochir 146:785–802

    Article  CAS  Google Scholar 

  24. Bakhsheshian J, Jin DL, Chang KE, Strickland BA, Donoho DA, Cen S et al (2016) Risk factors associated with the surgical management of craniopharyngiomas in pediatric patients: analysis of 1961 patients from a national registry database. Neurosurg Focus 41:E8

    Article  Google Scholar 

  25. de Vile CJ, Grant DB, Hayward RD, Kendall BE, Neville BG, Stanhope R (1996) Obesity in childhood craniopharyngioma: relation to post-operative hypothalamic damage shown by magnetic resonance imaging. J Clin Endocrinol Metab 81:2734–2737

    PubMed  Google Scholar 

  26. Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, Blaser SI (1992) Aggressive surgical management of craniopharyngiomas in children. J Neurosurg 76:47–52

    Article  CAS  Google Scholar 

  27. Sterkenburg AS, Hoffmann A, Gebhardt U, Warmuth-Metz M, Daubenbuchel AM, Muller HL (2015) Survival, hypothalamic obesity, and neuropsychological/psychosocial status after childhood-onset craniopharyngioma: newly reported long-term outcomes. Neuro Oncol 17:1029–1038

    Article  Google Scholar 

  28. Poretti A, Grotzer MA, Ribi K, Schonle E, Boltshauser E (2004) Outcome of craniopharyngioma in children: long-term complications and quality of life. Dev Med Child Neurol 46:220–229

    Article  Google Scholar 

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Acknowledgements

We thank all participating colleagues who contributed to this study.

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Authors and Affiliations

  1. Department of Pediatrics, Beijing Tiantan Hospital Affiliated To Capital Medical University, Beijing, 100070, China

    Deng Yaxian, Yao Chunmei, Xu Juanyu & Wang Lei

  2. Department of Neurosurgery, Beijing Tiantan Hospital Affiliated To Capital Medical University, Beijing, 100070, China

    Gong Jian

  3. Outpatient Department, Beijing Children’s Hospital Affiliated To Capital Medical University, Beijing, 100045, China

    Zhao Chengsong

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  1. Deng Yaxian
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Correspondence to Deng Yaxian.

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Yaxian, D., Chunmei, Y., Juanyu, X. et al. An analysis of clinical characteristics and postoperative complications in children craniopharyngioma. Childs Nerv Syst 37, 3033–3040 (2021). https://doi.org/10.1007/s00381-021-05277-7

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  • DOI: https://doi.org/10.1007/s00381-021-05277-7

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