ESPE Abstracts

Background: The HPAT multi-disciplinary meeting (MDT) was set up in 2011 with the aim to improve collaboration with other hospitals treating children with rare paediatric suprasellar brain tumours. It is a monthly remote meeting conducted virtually.

Objective: To evaluate the impact of COVID19 pandemic by comparing the number of meetings, cases (news/previously discussed), diagnosis, attendees, specialties, centres and outcomes (review of diagnosis, investigation plan, management and follow-up) pre and post-covid.

Methods: Retrospective descriptive study conducted between January 2019 and April 2021. Data was collected from the minutes generated after each patient discussion.

Results: PRE-COVID (January 2019-February 2020): 12 meetings were held and 42 cases discussed (median 3/meeting, range: 3-5): 8 craniopharyngiomas, 6 prolactinomas, 6 thickened pituitary stalks, 5 Rathke’s cysts, 5 astrocytomas, 2 teratomas, 2 germinomas, 3 non-functioning pituitary adenomas, 1 optic pathway glioma, 1 pars intermedia cyst, 1 pineal papillary tumour, 1 ectopic pituitary gland and 1 Cushing disease 32 were new cases (76%) and 10 previously discussed (24%). 119 professionals attended (median 9/meeting, range: 5-15) from 5 different specialties: 92 endocrinologists (77.3%), 9 oncologists (7.5%), 8 neurosurgeons (6.7%), 8 radiologists (6.7%) and 1 nephrologist. 12 centres participated (all from the UK). Diagnosis was reviewed in 18 cases (43%), investigation plan in 19 (45%), management in 19 (45%) and follow-up in 16 (38%). POST-COVID (March 2020-April 2021): 11 meetings were held (March, April and May 2020 cancelled due to the pandemic) and 50 cases discussed (median 4/meeting, range: 3-6) : 9 thickened pituitary stalks, 8 craniopharyngiomas, 8 prolactinomas, 4 Rathke’s cysts, 3 pituitary adenomas, 2 Cushing disease, 1 germinoma and 1 astrocytoma. 43 were new cases (86%) and 7 previously discussed (14%). 227 professionals attended (median 21/meeting, range: 17-26) from 4 different specialties: 169 endocrinologists (74.4%), 30 oncologists (13.2 %), 16 neurosurgeons (7.04 %), 12 radiologists (5.2 %). 19 centres participated including UK, Ireland and the Netherlands. Diagnosis was reviewed in 24 cases (48%), investigation plan in 33 (66%), management in 21 (42%) and follow-up in 24 (48%).

Conclusion: It is clear there is an increasing interest in participating in the HPAT MDT despite the current COVID pandemic. The number of cases presented, professionals engaged and centres involved has actually increased significantly during the COVID period. Therefore, a national, regular, virtual HPAT MDT is feasible and welcomed, facilitating dialogue amongst a wider specialist professional group and benefiting the management of the patients with rare hypothalamo-pituitary axis tumours.