Characteristics and factors influencing hypothalamic pituitary dysfunction in patients with craniopharyngioma

Ying Guo; Lili Pei; Yuzheng Li; Chunde Li; Songbai Gui; Ming Ni; Pinan Liu; Yazhuo Zhang; Liyong Zhong

doi:10.3389/fendo.2023.1180591

Characteristics and factors influencing hypothalamic pituitary dysfunction in patients with craniopharyngioma

Front Endocrinol (Lausanne). 2023 Jun 2:14:1180591. doi: 10.3389/fendo.2023.1180591. eCollection 2023.

Authors

Ying Guo¹, Lili Pei¹, Yuzheng Li¹, Chunde Li², Songbai Gui², Ming Ni², Pinan Liu², Yazhuo Zhang³, Liyong Zhong¹

Affiliations

¹ Department of Endocrinology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.

Abstract

Background: Craniopharyngioma is a benign tumor originating from the sellar region. Damages in this area caused by the tumor itself, surgery, or radiotherapy may result in severe hypothalamic-pituitary dysfunction (HPD) and eventually lead to a significant impairment in the long-term quality of life of patients. This study aimed to investigate the characteristics of HPD in patients with adamantinomatous craniopharyngioma (ACP) or papillary craniopharyngioma (PCP) and to identify the factors affecting HPD after surgery.

Methods: In this single-center retrospective study, a total of 742 patients with craniopharyngioma were included. The neuroendocrine function of these patients before and after surgery was investigated. The differences in hypothalamic-pituitary function between the ACP and PCP groups were compared. The factors influencing the aggravation of HPD after surgery were identified.

Results: The median follow-up after surgery was 15 months. Before surgery, the proportion of patients with diabetes insipidus (DI) and hyperprolactinemia in the PCP group was significantly higher than that in the ACP group (P<0.01), and the proportion of patients with adrenocortical hypofunction in the PCP group was significantly lower than that in the ACP group (P=0.03). Most cases of ACP originated in the sellar region, while most cases of PCP originated in the suprasellar region (P<0.01). More patients experienced adenohypophyseal hypofunction, DI, and hypothalamic obesity at postoperative follow-up than at onset in both the ACP and PCP groups (both P<0.01), with a higher increase observed in the ACP group (P<0.01). Older age at CP onset, tumor recurrence or progression, and ACP type were risk factors for postoperative aggravation of HPD in CP patients.

Conclusion: Surgical treatment significantly aggravated HPD in both the ACP and PCP groups, but the specific characteristics and risk factors leading to aggravation were different between the two groups.

Keywords: adamantinomatous craniopharyngioma; clinical prognosis; endocrine function; hypothalamic syndrome; papillary craniopharyngioma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Craniopharyngioma* / complications
Craniopharyngioma* / surgery
Diabetes Insipidus*
Humans
Hypothalamic Diseases* / complications
Neoplasm Recurrence, Local / pathology
Pituitary Diseases*
Pituitary Neoplasms* / complications
Pituitary Neoplasms* / pathology
Pituitary Neoplasms* / surgery
Quality of Life
Retrospective Studies

Grants and funding

Funding from Beijing Municipal Science & Technology Commission (grant number Z181100001718122) awarded to LZ.