Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain
| Autor: | Victor Rodríguez Berrocal, Miguel Paja, Fernando Cordido, Fernando Guerrero-Pérez, María Dolores Moure Rodríguez, Carles Villabona, Almudena Vicente, Cristina Álvarez-Escolá, Susan M. Webb, Tomás Martín, Elena Dios Fuentes, Sonia Gaztambide, Eva Venegas-Moreno, Concepción Blanco, Ignacio Nocete, Ignacio Bernabeu, Jessica Ares, Natividad González Rivera, Betina Biagetti, Juan J. Díez, Rocío Villar-Taibo, Mariela Glerean, Pedro Iglesias, Alfonso Soto-Moreno |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Aging Endocrinology Diabetes and Metabolism Population Neurosurgery Diabetes insipidus 030209 endocrinology & metabolism Hypopituitarism Pituitary neoplasms Therapeutic outcome 030218 nuclear medicine & medical imaging 03 medical and health sciences Cellular and Molecular Neuroscience Craniopharyngioma Visual field defects 0302 clinical medicine Endocrinology Elderly Internal medicine medicine Humans Pituitary Neoplasms education Aged Retrospective Studies Aged 80 and over education.field_of_study Endocrine and Autonomic Systems business.industry Mortality rate Subtotal Resection medicine.disease Spain Female Headaches medicine.symptom business |
| Zdroj: | NEUROENDOCRINOLOGY r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname RUC. Repositorio da Universidade da Coruña |
| ISSN: | 0028-3835 |
| Popis: | Background: Craniopharyngioma (CP) is a rare tumor in the elderly whose clinical features and prognosis are not well known in this population. Aim: To evaluate the clinicopathological features and therapeutic outcomes of CP diagnosed in the elderly. Patients and Methods: This was a retrospective, multicenter, national study of CP patients diagnosed over the age of 65 years and surgically treated. Results: From a total of 384 adult CP patients, we selected 53 (13.8%) patients (27 women [50.9%], mean age 72.3 ± 5.1 years [range 65–83 years]) diagnosed after the age of 65 years. The most common clinical symptoms were visual field defects (71.2%) followed by headache (45.3%). The maximum tumor diameter was 2.9 ± 1.1 cm. In most patients, the tumor was suprasellar (96.2%) and mixed (solid-cystic) (58.5%). The surgical approach most commonly used was transcranial surgery (52.8%), and more than half of the patients (54.7%) underwent subtotal resection (STR). Adamantinomatous CP and papillary CP were present in 51 and 45.1%, respectively, with mixed forms in the remaining. Surgery was accompanied by an improvement in visual field defects and in headaches; however, pituitary hormonal hypofunction increased, mainly at the expense of an increase in the prevalence of diabetes insipidus (DI) (from 3.9 to 69.2%). Near-total resection (NTR) was associated with a higher prevalence of DI compared with subtotal resection (87.5 vs. 53.6%, p = 0.008). Patients were followed for 46.7 ± 40.8 months. The mortality rate was 39.6% with a median survival time of 88 (95% CI: 57–118) months. DI at last visit was associated with a lower survival. Conclusion: CP diagnosed in the elderly shows a similar distribution by sex and histologic forms than that diagnosed at younger ages. At presentation, visual field alterations and headaches are the main clinical symptoms which improve substantially with surgery. However, surgery, mainly NTR, is accompanied by worsening of pituitary function, especially DI, which seems to be a predictor of mortality in this population. |
| Databáze: | OpenAIRE |
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