Long-term outcomes in patients with adult-onset craniopharyngioma

Prerna Dogra, Lucia Bedatsova, Jamie J. Van Gompel, Caterina Giannini, Diane M. Donegan, Dana Erickson

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Craniopharyngiomas are nonmalignant sellar and parasellar tumors exhibiting a bimodal age distribution. While the outcomes following treatment in patients with childhood-onset craniopharyngiomas are well characterized, similar information in adult-onset craniopharyngiomas is limited. We aimed to describe the long-term outcomes (weight and metabolic parameters, mortality) in patients with adult-onset craniopharyngioma following treatment. Methods: Patients with adult-onset craniopharyngioma with initial treatment (1993–2017) and >6 months of follow-up at our institution were retrospectively identified. Body mass index (BMI) categories included obese (BMI ≥ 30 kg/m2), overweight (BMI 25–29.9 kg/m2), and normal weight (BMI < 25 kg/m2). Results: For the 91 patients with adult-onset craniopharyngioma (44% women, mean diagnosis age 48.2 ± 18 years) over a mean follow-up of 100.3 ± 69.5 months, weight at last follow-up was significantly higher than before surgery (mean difference 9.5 ± 14.8 kg, P < 0.001) with a higher percentage increase in weight seen in those with lower preoperative BMI (normal weight (20.7 ± 18%) vs. overweight (13.3 ± 18.0%) vs. obese (6.4 ± 15%), P = 0.012). At last follow-up, the prevalence of obesity (62 vs. 40.5%, P = 0.0042) and impaired glucose metabolism (17.4% vs. 34%, P = 0.017) increased significantly. All-cause mortality was 12%, with the average age of death 71.9 ± 19.7 years (average U.S. life expectancy 77.7 years, CDC 2020). Conclusion: Patients with adult-onset craniopharyngioma following treatment may experience weight gain, increased prevalence of obesity, impaired glucose metabolism, and early mortality. Lower preoperative BMI is associated with a greater percentage increase in postoperative weight.

Original languageEnglish (US)
Pages (from-to)123-134
Number of pages12
JournalEndocrine
Volume78
Issue number1
DOIs
StatePublished - Oct 2022

Keywords

  • Body mass index
  • Hypothalamic injury
  • Metabolic comorbidities
  • Obesity
  • Weight gain

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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