Markers of recurrence and long-term morbidity in craniopharyngioma: a systematic analysis of 171 patients
| Autor: | Fabrice Bonnet, A. Gautier, Ariane Godbout, Mathieu Coudert, Gilles Brassier, Catherine Grosheny, Laurent Riffaud, Philippe Touraine, Christian Sainte-Rose, Marc de Kerdanet, Carine Courtillot, Christel Jublanc, Elisabeth Thibaud, Isabelle Tejedor, Jean-Yves Poirier, Remy Van Effenterre |
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| Přispěvatelé: | Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d'endocrinologie diabétologie et nutrition [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Hôpital Anne-de-Bretagne, Endocrinology Division, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM)-Université de Montréal (UdeM)-Department of Medicine, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre et Marie Curie - Paris 6 (UPMC), Modeling in Clinical Research, Université Pierre et Marie Curie - Paris 6 (UPMC)-EA 3974, Service de Pédiatrie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de neurochirurgie [Rennes] = Neurosurgery [Rennes], CHU Pontchaillou [Rennes], Service de neurochirurgie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Craniopharyngioma Study Group, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-Hôpital Anne-de-Bretagne, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -CHU Pontchaillou [Rennes]-Hôpital Anne-de-Bretagne, Centre de recherche du Centre Hospitalier de l'Université de Montréal ( CRCHUM ) -Department of Medicine, Department of Endocrinology and Reproductive Medicine, CHU Pitié-Salpêtrière [APHP]-Centre de Référence des Maladies Endocriniennes rares de la croissance et des maladies gynécologiques rares, Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -EA 3974, Department of Biostatistics and Medical Informatics, CHU Pitié-Salpêtrière [APHP], Department of Endocrinology and Metabolism, Service de neurochirurgie [Rennes], Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Department of Neurosurgery, Le Corre, Morgane |
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
Pediatrics MESH : Retrospective Studies Endocrinology Diabetes and Metabolism Clinical Biochemistry MESH : Child Preschool Biochemistry MESH: Craniopharyngioma Cohort Studies Craniopharyngioma 0302 clinical medicine Endocrinology MESH : Child Quality of life MESH: Child MESH : Female MESH : Craniotomy [ SDV.IB ] Life Sciences [q-bio]/Bioengineering Age of Onset Child MESH: Cohort Studies [SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism MESH : Prognosis MESH: Middle Aged MESH : Neoplasm Recurrence Local MESH: Follow-Up Studies MESH : Adult [ SDV.MHEP.EM ] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism Middle Aged [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism Prognosis MESH : Age of Onset 3. Good health 030220 oncology & carcinogenesis Child Preschool MESH: Survival Analysis MESH : Social Adjustment Female [SDV.IB]Life Sciences [q-bio]/Bioengineering France Social Adjustment MESH: Neoplasm Recurrence Local Craniotomy Cohort study MESH: Intracranial Hypertension Adult medicine.medical_specialty Adolescent MESH : Male MESH: Age of Onset MESH: Craniotomy MESH : Cohort Studies Context (language use) MESH: Prognosis 03 medical and health sciences MESH : Intracranial Hypertension MESH : Adolescent Internal medicine MESH : Craniopharyngioma medicine Humans MESH : Middle Aged MESH : France Survival rate Survival analysis Retrospective Studies [SDV.IB] Life Sciences [q-bio]/Bioengineering MESH: Adolescent MESH: Humans business.industry MESH : Humans Biochemistry (medical) MESH: Child Preschool MESH: Quality of Life MESH : Follow-Up Studies Retrospective cohort study MESH: Adult MESH: Retrospective Studies MESH : Quality of Life medicine.disease Survival Analysis MESH: Social Adjustment MESH: Male Surgery MESH: France Quality of Life MESH : Survival Analysis Age of onset Intracranial Hypertension Neoplasm Recurrence Local business MESH: Female 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Clinical Endocrinology and Metabolism Journal of Clinical Endocrinology and Metabolism, Endocrine Society, 2012, 97 (4), pp.1258-67. ⟨10.1210/jc.2011-2817⟩ Journal of Clinical Endocrinology and Metabolism, 2012, 97 (4), pp.1258-67. ⟨10.1210/jc.2011-2817⟩ Journal of Clinical Endocrinology and Metabolism, Endocrine Society, 2012, 97 (4), pp.1258-67. 〈10.1210/jc.2011-2817〉 |
| ISSN: | 0021-972X 1945-7197 |
| DOI: | 10.1210/jc.2011-2817⟩ |
| Popis: | International audience; CONTEXT: Craniopharyngiomas are often associated with an unfavorable prognosis, but data on their long-term consequences are sparse. OBJECTIVE: The aim of the study was to identify markers of recurrence and factors associated with compromised social rehabilitation and altered quality of life in a large cohort of patients with either childhood-onset (CO) or adult-onset craniopharyngioma. METHODS: Retrospective analysis was performed for 171 patients treated for craniopharyngioma in two academic centers in France between 1972 and 2009. For each subject, data were collected concerning clinical presentation, imaging features, visual sequelae, endocrine and metabolic impact, treatment modalities (surgery, radiotherapy), recurrence-free survival rate, and social insertion, as well as answers to the WHO-QOL BREF questionnaire. RESULTS: A total of 65 CO and 106 adult-onset patients were reviewed. If CO was diagnosed before the age of 10 yr, this was associated with a higher incidence of obesity, blindness, and panhypopituitarism, and only 40.7% of subjects had adequate work or school attendance compared to 72.4% of patients with later disease onset. Initial symptoms of intracranial hypertension (SIHT), pterional surgery, and multiple surgery were associated with obesity and poorer social insertion. No determinant of quality of life was identified. In the subgroup of patients treated in the 1990s and later, the progression rate was 59.4% in patients with residual tumor on magnetic resonance imaging compared with a 19.8% recurrence rate in the group with apparently complete resection. Recurrence/progression correlates significantly with male gender, early onset (before 10 yr), and SIHT, but only SIHT at presentation remained a significant predictor with multivariate analysis. CONCLUSIONS: Craniopharyngioma continues to be associated with severe outcomes. Higher morbidity rates are found in patients with early-onset disease (before 10 yr), initial SIHT, or in whom pterional surgery was required. Markers of recurrence are difficult to identify, with SIHT being the most powerful predictor. |
| Databáze: | OpenAIRE |
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