84 Abstracts ingediend voor het Amsterdam Kindersymposium 2013. Risk factors for hypothalamic obesity after treatment for craniopharyngioma: a joint 10 ...
Risk factors for hypothalamic obesity after treatment for craniopharyngioma: a joint 10 years evaluation of all patients treated in the VUMC and AMC. Ruud W.H. Meijneke (1), Antoinette Y.N. Schouten-van Meeteren (2), Liesbeth Reneman (3), Martijn Finken (4), Peter H. Bisschop (5), Wouter van Furth (6) Hanneke M. van Santen (7) (1) Student (UMCG) scientific project, department of pediatric oncology and department of pediatric endocrinology, Emma Children’s Hospital, AMC (2) Department of pediatric oncology, Emma Children’s Hospital, AMC (3) Department of radiology, AMC (4) Department of pediatric endocrinology, VUMC (5) Department of endocrinology, AMC (6) Department of neurosurgery, AMC (7) Department of pediatric endocrinology, Emma Children’s Hospital, AMC
INTRODUCTION Hypothalamic obesity is a major concern in patients treated for craniopharyngioma. The goal of this study was to define risk factors for hypothalamic obesity aiming to improve the decisions in treatment options. METHODS
We retrospectively reviewed all charts of patients treated for craniopharyngioma between January 2002 and May 2012. Eligible cases were identified through our pathology database (n=42). For pediatric patients, obesity was defined as a body mass index (BMI) > + two standard deviations from the mean. In adult patients, obesity was defined as a BMI greater than 30 kg/m2.
RESULTS
Thirty-six patients (22 children) could be included with a mean follow-up of 53 months. Twenty-one (58.3%) patients had gross total resection and 15 (41.7%) partial resection or biopsy. Immediate radiotherapy was performed in 7 patients. Nine patients had a relapse. At last follow-up, obesity was present in 20 patients (55.6%), and more frequent in pediatric than in adult patients (68.2% versus 35.7%). Multivariate logistic regression showed age at diagnosis (p = 0.028) and the degree of resection (p = 0.046) to be significantly related to the development of obesity.
CONCLUSION
Hypothalamic obesity occurs more frequently in younger patients, and seems to be more related to the degree of surgical intervention than the size of the tumor at presentation. The high rate of hypothalamic obesity and its negative influence on quality of life, incites us to recommend partial resection if the hypothalamus is involved. Further prospective research should be performed to develop a risk-based treatment algorithm.
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Abstracts ingediend voor het Amsterdam Kindersymposium 2013
