Background: Severe obesity due to hypothalamic involvement has major impact on prognosis in long-term survivors of childhood-onset craniopharyngioma. The long-term effects of rehabilitation efforts on weight development and obesity in these patients are not analysed up to now.
Method: 108 patients with childhood-onset craniopharyngioma recruited in HIT Endo before 2001 were included in the study. Long-term weight development (BMI SDS after >10 years follow-up) was analysed in regard to rehabilitation, which was performed in 31 of 108 (29%) patients (one rehabilitation in four patients (13%), more than one in 21 patients (68%), six patients unknown) in 13 German rehabilitation clinics.
Results: 84% of patients underwent rehabilitation in order to reduce hypothalamic obesity (BMI >+2 SD), whereas 12% of patients were normal weight. Childhood-onset craniopharyngioma patients with rehabilitation presented with higher BMI at diagnosis (median BMI: +1.32 SD; range: −1.08 to +7.00 SD) and at last evaluation (median BMI: +4.93 SD; range: −0.20 to +13.13 SD) when compared with patients without rehabilitation (median BMI at diagnosis: +0.24 SD; range: −2.67 to +6.98 SD; BMI at evaluation: +2.09 SD; range: −1.48 to +10.23 SD). A long-term weight reducing effect of rehabilitation was no detectable regardless of degree of obesity, frequency of rehabilitation, and hospital of rehabilitation.
Conclusion: Treatment options for hypothalamic obesity in terms of rehabilitation are limited. Accordingly, strategies for prevention of hypothalamic lesions and psychosocial effects of rehabilitation are currently in focus for improvement of prognosis in childhood craniopharyngioma patients.
Funding: German Childhood Cancer Foundation, Bonn, Germany.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology