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Temporal trends in craniopharyngioma management and long-term endocrine outcomes: a multicentre cross-sectional study.

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Title: Temporal trends in craniopharyngioma management and long-term endocrine outcomes: a multicentre cross-sectional study.
Authors: Hussein, Z
Glynn, N
Martin, N
Alkrekshi, A
Mendoza, N
Nair, R
McCullough, K
Marcus, HJ
Dorward, N
Grieve, J
Fersht, N
Dyson, E
Bouloux, P-M
Druce, M
Baldeweg, SE
Item Type: Journal Article
Abstract: BACKGROUND: The optimal management of craniopharyngiomas remains controversial. OBJECTIVES: To examine temporal trends in the management of craniopharyngioma with a focus on endocrine outcomes. METHODS: This was a cross-sectional, multicentre study. Patients treated between 1951 and 2015 were identified and divided into four quartiles. Demographics, presentation, treatment and outcomes were collected. RESULTS: In total, 142 patients with childhood onset craniopharyngioma (48/142; 34%) and adult onset disease (94/142; 66%) were included. The median follow-up was 15 years (IQR 5 - 23 years). Across quartiles, there was a significant trend towards using transsphenoidal surgery (p <0.0001). The overall use of radiotherapy was not different among the four quartiles (p = 0.33). At the latest clinical review, the incidence of GH, ACTH, gonadotrophins deficiencies as well as anterior panhypopituitarism fell significantly across the duration of the study. Anterior panhypopituitarism was not affected by treatment modality (surgery vs surgery and radiotherapy) (p = 0.23). There was no difference in the incidence of high BMI (≥ 25 kg/m2 ) among the four quartiles (p = 0.14). BMI was higher in patients who treated with surgery and radiotherapy than those treated with surgery only (p = 0.006). Tumour regrowth occurred in 51 patients (51/142; 36%) with no difference in regrowth among quartiles over the time course of the study (p = 0.15). CONCLUSION: We demonstrate a significant reduction in panhypopituitarism in craniopharyngioma patients over time, most likely because of a trend towards more transsphenoidal surgery. However, long term endocrine sequelae remain common and lifelong follow-up is required.
Issue Date: Feb-2021
Date of Acceptance: 10-Aug-2020
URI: http://hdl.handle.net/10044/1/82904
DOI: 10.1111/cen.14334
ISSN: 0300-0664
Publisher: Society for Endocrinology
Start Page: 242
End Page: 249
Journal / Book Title: Clinical Endocrinology
Volume: 94
Issue: 2
Copyright Statement: © 2020 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: Science & Technology
Life Sciences & Biomedicine
Endocrinology & Metabolism
transsphenoidal surgery
transsphenoidal surgery
Transsphenoidal surgery
Endocrinology & Metabolism
1103 Clinical Sciences
1114 Paediatrics and Reproductive Medicine
Publication Status: Published
Conference Place: England
Open Access location: https://onlinelibrary.wiley.com/doi/10.1111/cen.14334
Online Publication Date: 2020-09-19
Appears in Collections:Department of Surgery and Cancer
Faculty of Medicine

This item is licensed under a Creative Commons License Creative Commons