Long-term endocrine complications and quality of life in pediatric-onset craniopharyngioma: a single-center cohort study

Information from the abstract

BACKGROUND: Craniopharyngioma is a benign yet locally aggressive brain tumor that causes substantial long-term endocrine, metabolic, visual, and hypothalamic morbidities, leading to impaired quality of life (QoL). However, data on QoL and long-term outcomes in Thai pediatric patients remain limited. METHODS: This study included two components: a retrospective cohort review of long-term endocrine, metabolic, and visual outcomes in patients aged ≤ 25 years with histologically confirmed pediatric-onset craniopharyngioma diagnosed between 2000 and 2023 at Siriraj Hospital, and a cross-sectional assessment of quality of life using the Pediatric Quality of Life Inventory (PedsQL 4.0). Factors associated with quality of life were evaluated using linear regression. RESULTS: Eighteen patients were included (median age at diagnosis 6.8 years). Postoperative endocrine deficiencies were common, including growth hormone deficiency (88.9%), vasopressin deficiency (100%) and gonadotropin deficiency (93.3% of evaluable patients). Residual/recurrent disease developed in 55.6% of patients during follow-up. Metabolic complications were common, overweight and obesity at recent follow-up were observed in 6 (33.3%) and 4 (22.2%) patients, respectively. Among screened patients (88.9%), dyslipidemia occurred in 62.5%, metabolic dysfunction-associated steatotic liver disease in 25.0%, and type 2 diabetes in one patient. Height SDS declined and BMI SDS increased significantly over time (p < 0.05). Visual impairment progressed in 27.8%. The mean PedsQL score was 68.8 ± 15.2. In exploratory analyses, obesity was associated with poorer quality of life. CONCLUSIONS: Pediatric craniopharyngioma carries a substantial burden of long-term endocrine, metabolic, and visual morbidity, adversely affecting growth and quality of life. Lifelong, multidisciplinary follow-up is essential to optimize outcomes.

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Related topics: Pituitary Gland Disorders and Treatments · Growth Hormone and Insulin-like Growth Factors · Adrenal and Paraganglionic Tumors